'Postcode lottery' for new breast cancer drug

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Doctors and breast-cancer charities welcomed the decision yesterday to allow two expensive drugs for treating the disease to become widely available on the NHS.

Doctors and breast-cancer charities welcomed the decision yesterday to allow two expensive drugs for treating the disease to become widely available on the NHS.

It was hailed as a "significant milestone" that will prolong the life and improve the quality of life of up to 5,000 women with advanced breast cancer.

But campaigners said that without extra cash some women could still be subjected to "postcode lottery prescribing" and refused the drugs because of financial constraints. The National Institute for Clinical Excellence (NICE), a government advisory body, said that two taxanes (a generic group of drugs), Taxol and Taxotere (the trade names), should be given to women whose cancer had not responded to standard chemotherapy. The drugs have been licensed in Britain for several years but have not been widely used because they are expensive. A treatment costs £1,500; average cost per patient is £4,000.

In Britain 30,000 women a year are diagnosed with breast cancer and 14,000 die of it. NICE estimates the cost to the NHS of the new drugs will be £20m a year. As it is believed 1,000 of the 5,000 who would benefit from the drugs are already being treated, the additional cost to the NHS is estimated at £16m a year.

Andrew Dillion, NICE chief executive, said: "The institute's guidance is based on a very careful consideration of the evidence and I believe all those involved in cancer services in the NHS will welcome it." Last month NICE advised doctors to use Taxol with the drug cisplatin or carboplatin as standard therapy after surgery for patients with advanced ovarian cancer. But it delayed the decision on Taxotere.

Delyth Morgan, chief executive of Breakthrough Breast Cancer, said: "Without extra government funding we may still see evidence of postcode prescribing. NICE has based its cost calculations upon the suitability of 5,000 women for these drugs. Doctors should base their decisions on clinical judgement and must not be influenced by financial constraints."

David Campbell-Morrison, director of the Campaign for Effective and Rational Treatment, said health authorities must make the funding available for taxanes to treat ovarian and advanced breast cancer without impacting on the budgets for other types of cancer. "The onus to find the money should not fall on the cancer centres. If it does, we risk replacing postcode prescribing with tumour-type prescribing as doctors are forced to rob Peter to pay Paul."

The recommendation means all women with advanced breast cancer, regardless of where they live, should have access to the drugs. Until now it has been a matter of chance whether patients were prescribed the drugs.

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