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London Women Denied Herceptin in Cancer Drug Postcode Lottery

Posted on: Thursday, 2 March 2006, 21:00 CST

By REBECCA SMITH; ELLEN WIDDUP

NINE women in London have been told they will not be given the lifesaving breast cancer drug Herceptin on the NHS.

A survey carried out by the Evening Standard has shown that women in some boroughs are being given the drug but in others they are refused it - effectively a postcode lottery.

Fourteen women are still waiting to find out if they will get Herceptin on the NHS or face a bill of thousands of pounds a year to buy it privately.

The drug, which can reduce the risk of some breast cancers returning by almost 50 per cent, costs about Pounds 20,000 a year per patient.

It is not yet licensed for use in early-stage cancers but doctors can ask a local primary care trust to fund it on a caseby-case basis if it is thought that the patient would benefit.

Some of the 32 London trusts have granted Herceptin to every woman whose doctor thinks she needs it, while others have refused all requests.

The remainder have given it to some patients but not to others. It is feared trusts are using social criteria, such as whether the woman is a single mother, in making their decisions.

Campaigners say the confusion is causing patients extra worry.

Health Secretary Patricia Hewitt said yesterday that a decision on whether to recommend Herceptin for all women in the early stages of HER2 positive cancer will be made in the summer.

The decision has been delayed as makers Roche collect data from clinical trials and apply for a licence for its use in these cases.

Ms Hewitt has also made it clear that the trusts must not refuse the drug on grounds of cost alone but, after the Standard's revelation that the NHS in London is facing Pounds 182million debts this year, some are understood to be considering not funding Herceptin until it has been licensed by European regulators.

Ten London trusts have approved all requests for Herceptin. Only Hillingdon, facing a Pounds 27 million deficit, has refused the two requests that it received, citing a "difficult choices policy".

Sutton and Merton has received 13 requests for the drug and has approved 11.

One was refused and the other is still being considered .

Wandsworth granted eight requests and refused six.

National cancer director Professor Mike Richards said the Government cannot pre-empt its licensing authority and order trusts to fund Herceptin.

But he added: "I personally feel that women who fit the eligibility criteria are in exceptional circumstances in that they have an aggressive form of breast cancer and Herceptin offers the potential for changing their outcome very substantially."

Dr Sarah Rawlings of Breakthrough Breast Cancer said: "All women who could benefit from Herceptin should receive it. Many doctors want to prescribe the drug but their PCTs will not let them."

Dr Gill Morgan, chief executive of the NHS Confederation, which represents most NHS organisations, said: " Herceptin has not yet been licensed for early-stage breast cancer.

"The licensing and regulatory processes are there to ensure that new drugs are both safe and effective as well as to protect patients.

"It is the responsibility of both clinicians and managers at a local level to decide whether to prescribe Herceptin offlicence under exceptional circumstances."

. If you have been refused the drug, email herceptin@standard.co.uk

FOR TABLE REFER TO CUTTING

Source: Evening Standard; London (UK)

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