New guidance from NICE recommends trastuzumab (Herceptin) in early breast cancer but provides no extra funding.
Doctors at the Norfolk and Norwich University Hospital NHS Trust and the University of East Anglia said they would have to find £1.9 million a year to make Herceptin available to the patients who may be eligible. This becomes £2.3 million when the costs of testing and monitoring patients are added.
After auditing drug costs in their hospital’s cancer centre, they estimated that they could save £1.9 million by cutting chemotherapy and palliative care treatments.
This would enable them to treat 75 patients with Herceptin, but they would have to stop 355 patients receiving adjuvant treatment (16 of whom would be cured) or 208 patients receiving palliative chemotherapy.
Writing in the BMJ, the doctors argue that NICE should be given responsibility to decide what to cut to fund newly recommended technologies, or have the ability to allocate extra funds, rather than leaving rationing decisions to medical staff.