For many hundreds of women's fight against the cancer of breast the ruling by the courts has opened means of treatment. Three senior Court of Appeal judges said yesterday that the policy adopted by the Swindon NHS Primary Care Trust, of funding treatment with the drug Herceptin only in "exceptional circumstances", was irrational because it was not supported by any personal or clinical distinctions among eligible patients. The trust itself had insisted that financial considerations did not underlie its policy.
Ann Marie Rogers, a breast cancer patient, has won a landmark ruling that her local hospital acted unlawfully in refusing to supply her with a potentially life-saving treatment.
Jeremy Hughes, the chief executive of Breakthrough Breast Cancer, welcoming the judgment, said that, it could be hoped that this would send out clear messages to all PCTs, that Herceptin should be prescribed on the basis of clinical need, not cost. Herceptin is already being licensed for use in women with advanced breast cancer, and studies show that it may also be effective in preventing a recurrence of early-stage forms of the disease. The makers, of the drug, Roche, have claimed to have applied for a licence for early-stage treatment with Herceptin and the National Institute for Clinical Excellence has agreed to fast-track its appraisal of which patients should receive it on the NHS, but these two decisions are not expected until later this year. Till such time the PCTs have been told to act at their own discretion, and this has lead to widespread disparities in who receives the drug. It has been found in survey that only 10 % of eligible patients in some areas are given access to Herceptin, compared to 90% in others.
The ruling stated that it is now a matter for the PCT to reconsider its policy and to formulate a lawful policy upon which to base decisions in particular cases.
The chief executive of Swindon Primary Care Trust, said, that they welcome the clarity given by the court on the use of Herceptin. He stated that with this new judgment they would now include and restructure their policy by taking into consideration the points made by the court. The PCT will continue to treat all patients now and in the future with care and consideration, he said.
Meanwhile the Dr David Miles The British breast cancer expert who helped develop Herceptin last night criticised the growing hype over the so-called wonder drug. In his statement after the court ruling he said that a wonder drug is something that cures everyone who takes it with very few problems. Explaining that it is clearly not the case with Herceptin. He explained that people think that it would halve the rate of recurrence of cancer, but it wouldn't be so impressive when people understand that there could be maybe a fall from 20% to 10%.
His concerns were echoed by other senior doctors, among them Joe Collier, the professor of medicines policy at St George's Hospital Medical School, London, and David Kerr, professor of clinical pharmacology and cancer therapy at Oxford University.