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The real cost of Herceptin
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The cost of Herceptin for one PCT is nearly £2m a year, plus the cost of medical monitoring.
Herceptin is an unproven drug. That £2m a year, plus medical costs, will treat 75 patients.
The gap in the budget will prevent 355 people from receiving post-surgery treatment (about 20 of whom would be cured), or it will prevent 200 people from receiving palliative chemotherapy. Both treatments are proven to work.
Given that, I think it is a disgrace that the NHS is being forced to fund this drug, with no extra funding, simply because it is a fashionable drug. 75 people will prevent 355 people from getting treatment- that is shocking. Should the NHS be forced to fund this drug at the expense of others? I don't think so.
Herceptin is an unproven drug. That £2m a year, plus medical costs, will treat 75 patients.
The gap in the budget will prevent 355 people from receiving post-surgery treatment (about 20 of whom would be cured), or it will prevent 200 people from receiving palliative chemotherapy. Both treatments are proven to work.
Given that, I think it is a disgrace that the NHS is being forced to fund this drug, with no extra funding, simply because it is a fashionable drug. 75 people will prevent 355 people from getting treatment- that is shocking. Should the NHS be forced to fund this drug at the expense of others? I don't think so.
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i could fill up a page here with argumants for and against but :grump: ... can't be arsed...
And can we have a little look at what inefficient prescribing costs that trust?
Certainly in our trust if all the GPs followed the Community Pharmacists guidance and changed over all suitable patients from one brand of medication for high blood pressure to another that does the job as well if not better, then the money saved would more than cover the cost of the Herceptin demand.
Welcome to my world and the type of decision I have to make every week. My views on Herceptin are well know. If other patients had the full backing of a drug company (to pay their legal bills) and a condition which hits several emotional highs as Breast Cancer does, then we would see much more of this type of thing.
It isn't just that Breast Cancer is fashionable - it's emotive and grabs the media attention. The press coverage of the Swindon case is an example of that. The public, understandably, got behind the woman in that case. Shame they were never asked to decide what wasn't funded inorder to pay for her treatment and then confornted by a patient whose care had been cut...
Clinical trials. Which is how we know that it isn't actually as effective as the drug companies would want women to believe. You need to treat about four people just to get one good result - so it isn't £30k per patient, it's £120k per successful treatment and that is one hell of a huge bill - especially when you consider that we could employ three physiotherapists for that money and they could treat about 300 people each....
I can think of a whole raft of better investments TBH, but you main point is correct we could save a fortune.
erm clinical trials, thats how a drug becomes a proven treatment
there's plenty of people who would be willing to test it also
sadly resources will always be finite, thus a level of cost-benefit has to be done and sadly it wasnt done well here imo
As for employing 4 physios, would they actually be doing physio? Or would they be sitting in meetings and doing paperwork?
Since moving back home I'm starting to see why the NHS is short on money. My mum has an equivalent Community Dental grade to being 1 level below a consultant.
This week she's done 8 sessions (4 on bank) of which 2.5 were clinical and treating patients. The rest were paperwork/meetings.
Possibly if they had clinicians doing clinical work for most of their time, rather than paying them to do paperwork and had decent secretarial cover then there might be a bit more money around for drugs.
At least money spent on things like Herceptin goes towards treating patients.
it was unlicesned at the time, for it's poor sucess rate
Hence why it took so long to get a licence. It does work, but only in 1:4 cases. NICE, under political and public (for that read medai and pharma) pressure backed it only recently. That was after the Sec State (Lady Hewitt of Ivory Towers) told PCTs that they would need to justify why they didn't fund it (thus telling them to make sure that they did), which came after the Swindon case (which was, I understand, funded by the relevant pharma company), which came after PCTs pointed out that the drug wasn't licenced for this use because the clinical trial weren't conclusive to it's effectiveness.
hang on a second, aren't people clamouring for clinicans to be involved in decision making?
I actually agree with you, I'd much rather that they stuck to doing what they are trained to do.
Does it bollocks. It goes into the huge profits which the pharma industry makes. Do you really think that it costs them £30k to manufacture this drug?
Why do clinicians do paperwork?
It's because of the mass media frenzy about the "faceless bureaucrats" running the NHS. "Doctors should run the NHS!", they cried, and now they do- so instead of treating patients they are running meetings. People have got exactly what they wanted.
And that's why you get bollocks like this. Someone has to administrate, and it costs money. An administrator would be cheaper, but that's a waste of NHS funds (it could be buying more Herceptin, after all), so now doctors administrate instead of treat.
No, it goes towards the bottom line of the pharmaco who had enough money to fight a long media campaign to get an ineffective drug licensed.
No, it doesn't, but the media have fought a long campaign- aided by many politicians, I should add- to make the NHS look like its staffed by nobody but managers.
Although might be worth remembering there isn't a lot that's comparable in the private sector - with over 1 million employees and ranked between the 3rd and 5th largest employer in the world.