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Bitter Defeat for Breast Cancer Victim Over Drug Postcode Lottery

Posted on: Thursday, 16 February 2006, 21:00 CST

By NICK CRAVEN

PATRICIA HEWITT was accused of raising false hopes for thousands of women last night as breast cancer sufferer Ann Marie Rogers lost her legal battle for the 'wonder drug' Herceptin.

The Health Secretary said last October that primary care trusts should not refuse the drug on cost grounds for treatment of early- stage breast cancer.

But the High Court ruled yesterday that her words were merely 'guidance' and not binding on trusts. The verdict confirmed the existence of an NHS postcode lottery for Herceptin Swindon PCT refused it to Mrs Rogers but more than 20million people live in areas where the drug is available for early-stage cancer.

The 54-year-old mother of three, who called the PCT's decision 'a death sentence', was said last night to be devastated by the court defeat, although she was given permission to appeal.

Her solicitor said she had been 'fighting for her life' and felt the hopes of cancer sufferers up and down the country had been falsely built up by Miss Hewitt's statements.

Tory spokesman Andrew Lansley called on Miss Hewitt to immediately issue a clear direction to PCTs.

He said: 'Many women will have understood her statement to mean the end of the postcode lottery in Herceptin for early-stage cancer.' Christine Fogg, chief executive of the charity Breast Cancer Care, said the case 'highlights yet again the urgent need for the Department of Health to give clear direction.' Herceptin is licensed for treatment of late-stage breast cancer, but not yet for early-stage. It is claimed to halve the chances of the aggressive HER-2 form of the cancer returning, but a one-off course of 12 months costs around Pounds 26,000.

Mrs Rogers's case is the first involving Herceptin to come to court.

Other PCTs have backed down when patients challenged their refusal.

Now campaigners fear that yesterday's decision especially if it is endorsed by the Appeal Court may embolden PCTs to continue to refuse the drug until it is officially licensed for early-stage cancer, which could happen in the summer.

Mrs Rogers, a former restaurant manager from Haydon Wick, Swin- don, had sought a reversal of her local trust's decision, claiming that it was arbitrary and irrational and breached her human rights.

Mr Justice Bean, who expressed sympathy for her, said: 'Many primary care trusts have a policy of funding Herceptin treatment for early-stage breast cancer sufferers who are HER-2 positive, but Swindon's is not to provide such funding unless the individual case is exceptional.' The judge said many people would think the policy of the other authorities was better than Swindon's, but that was a matter for political debate and not an issue for the courts.

He said: 'The question for me is whether Swindon's policy is arbitrary and irrational and thus unlawful. I cannot say that it is.' Mrs Rogers has borrowed Pounds 5,000 for treatments so far, but says she cannot afford to pay further.

She first noticed a lump on her breast in October 2004. She went to her GP the following day and was given an appointment for a mammogram at Great Western Hospital in Swindon. In January 2005 she had a mastectomy and breast reconstruction, followed by chemotherapy and radiotherapy.

In the meantime her son discovered on the Internet that HER-2 breast cancer could be treated by Herceptin. Mrs Rogers was tested for HER-2 and found to be positive.

Both her GP and consultant oncologist recommended Herceptin, but the trust refused.

Yesterday she was joined in court by a group of fellow breast cancer sufferers dressed in pink T-shirts carrying the slogan Need Herceptin Straightaway. They live in North Staffordshire and have all been able to receive the drug.

Other health areas where Herceptin is available for patients with early-stage cancer include Cheshire and Merseyside, Greater Manchester, Hampshire and Isle of Wight, Leicestershire, Northamptonshire and Rutland, North and East Yorkshire and North Lincolnshire' Northumberland and Tyne and Wear, South West Peninsular, South Yorkshire, the Lancashire and South Cumbria Cancer Network, all PCTs in Norfolk and Northern Ireland and many in London, Staffordshire, Cambridgeshire and Somerset.

The drug's manufacturers, Roche, plan to apply to the European Medicines Evaluation Agency this month for a licence extension to treat earlystage cancer.

If approved, the drug could be licensed for such use throughout the EU by the middle of this year.

Roche also announced last week that it was making a submission to the NHS drug approval body, the National Institute for Health and Clinical Excellence.

This means that NICE should have completed its appraisal by the time the drug is licensed by the EMEA, and it could be rapidly approved for use across the NHS.

NICE said last night it was expecting to issue guidance in August.

The Department of Health said: 'Our position remains unchanged.

PCTs should not refuse to fund Herceptin for women with HER-2 earlystage breast cancer solely on the grounds of its cost.

'They need to take into consideration a whole range of factors. Ahead of a decision on licensing, or NICE appraisal, such decisions will continue to be made at a local level on a case-by-case basis.'

Source: Daily Mail; London (UK)

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