The recent hoohah back home in the UK regarding earlier Herceptin use in breast cancer has certainly proven controversial. Here’s the link to the story:

Herceptin News

Perhaps the most frustrating aspects of the situation are that a) other women in the same situation have been given the drug by their primary care trusts (PCT), leading to confusion over who should have access to drugs and b) do we really want the legal eagles making major health care decisions for patients?

The challenge the UK faces is that the different health authorities (HA) each have different policies and so what was formerly a national health service is rapidly becoming devolved to a regional one where the postcode (zipcode) may ultimately determine a patients’ fate. This creates a two tier health system.

The NHS aims to provide free health care to all, but it is still constrained by budgets and until the National Institute of Clinical Effectiveness (NICE) have conducted a full evaluation on it’s cost effectiveness, some people believe no-one should have it. They are not the speediest or most responsive of government bodies, though, and the extra hurdle to obtaining access to cancer drugs often leaves patients and physicians in limbo.

One could cynically assume that it is possible that the PCTs who are prescribing Herceptin are doing so to save face and avoid legal action, but at least they provide access to it for their citizens. One would actually hope that they may actually be aware of the recent positive data in the early breast cancer setting that was presented last year at both the American Society of Clinical Oncology and also at the San Antonio Breast Cancer Conference. To say that the data was dramatic would be an understatement.

In the end, one is left with the sad conclusion that it is the patients who lose out on this one.