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Woman loses bid to be allowed Herceptin on NHS

According to the Beeb;
"A breast cancer patient has lost her landmark legal challenge to be allowed the drug Herceptin on the NHS. Ann Marie Rogers, 53, had gone to court after she was denied the drug - which is not licensed for early-stage breast cancer - by Swindon NHS bosses. But the judge ruled that the trust had not been acting unlawfully. Mrs Rogers has been given leave to appeal against the court's decision, and will be able to receive Herceptin treatment until then. Mrs Rogers is in the early stages of breast cancer, but has an aggressive form of the disease." Click for details.

This is an extremely sensitive issue, so I'm going to tread carefully here. I sympathise hugely with this woman's plight. She could die potentially because of this, so this is not an issue to be treated lightly. The court made the judgement, however, on whether the policy of Swindon NHS bosses was unlawful. They decided it was not. Also, it should be noted that NICE hasn't yet given approval to this drug. Therefore, they have acted within the law. I pray this decision does not lead to more heartache for this woman.

What do you make of this verdict?
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Comments

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    Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    I was just amazed when I heard the acronym NICE...bit ironic eh? :(
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    Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    Its a tough one really, if you are going to allow people to use unlicenced drugs, whats the point in licencing them at all?

    However, the evidence seems to be there (in part) for the effectiveness of the drug.
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    Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    bongbudda wrote:

    However, the evidence seems to be there (in part) for the effectiveness of the drug.

    That's whats most irritating. I'm not the cleverist person, and the politics and laws behind all these sort of cases baffle me, but this is the second (news covered) appeal we've had in the last year (or so).

    This drug is supposed to be really helpful. And they're admitting they the public are right. Yet they wont bring it in....?
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    Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    nicx1811 wrote:
    This drug is supposed to be really helpful. And they're admitting they the public are right. Yet they wont bring it in....?

    Yes and no, as I understand it one study suggested that the drug can be quite effective if taken early in the cancer (its licenced for use late on). But thats it, at the moment it seems to be only one full study, which isnt enough to base a judgement on.
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    Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    Ahh now you see, that makes more sense.... in a way anyway.
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    Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    nicx1811 wrote:
    Ahh now you see, that makes more sense.... in a way anyway.

    Roche the drug company which owns the drug have been accused of dragging their feet over licence applications for earlier use, though why they would I dont know. Maybe they hope they can sell it without having to bother with a licence.
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    Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    And if she took it and died we all know who would be suing the trust.

    No-one can say I don't know in a deeply personal way the impact of cancer, but she shouldn't be given it. Not now.
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    Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    It's very expensive... at the end of the day you could probably save more lives with the money doing different treatments than allowing this drug before other options have been exhausted.
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    Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    The NHS screwing someone over again? never :eek:
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    Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    minimi38 wrote:
    The NHS screwing someone over again? never :eek:
    Well you could say that they are protecting her because the drug is unlicensed for her situation and they are protecting others by using their resources differently.
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    Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    Its going to be licensed by the summer anyway...
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    Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    I feel very sorry for this woman, and others in her position. She knows of a drug which MAY help her which her NHS trust will not prescribe. However i believe the trust are right not to. This drug is unlicensed, and has not received extensive enough trials to make the risk worthwhile at this point in time. Each NHS trust cannot supply every drug that every patient demands due to costs. One vial of Herceptin costs around £400 to produce...when you calculate the cost of a course of this drug, it does become expensive. Unfortunately the financial state of the NHS means doctors cannot prescribe every drug under the sun...rightly or wrongly, they have a budget to stick to.
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    Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    StarGalaxy wrote:
    This is an extremely sensitive issue, so I'm going to tread carefully here. I sympathise hugely with this woman's plight. She could die potentially because of this

    Sorry to be picky, but isnt it the cancer that is going to kill her, not the courts

    There is a difference between a courts decision killing someone, and deciding not to give her a drug which "may" potentially save her
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    Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    Good.

    The cost of that drug- a drug that has no proven benefits- could save the lives of hundreds of other people. It could save those with mental illness, it could save those with heart problems, it could save other cancer sufferers.

    I really do sympathise with this lady's plight, but she has rightly been found against in this judicial review.
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    Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    Kermit wrote:
    Good.

    The cost of that drug- a drug that has no proven benefits- could save the lives of hundreds of other people. It could save those with mental illness, it could save those with heart problems, it could save other cancer sufferers.

    I really do sympathise with this lady's plight, but she has rightly been found against in this judicial review.

    Too true...lots of people seem to think that the NHS has a bottomless pit of money....welll it doesn't, and those in control of the budget have to decide where best to spend those funds. Unfortunately spending all that money, on one patient, on an unlicensed drug, is just not viable :no:
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    Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    bongbudda wrote:
    However, the evidence seems to be there (in part) for the effectiveness of the drug.

    Not really, the efficacy of the drug is still in question. It costs £21k for one person to be treated for a year. Based on the current success rate, the NHS will have to spend £500k just to get a single success.
    minimi38 wrote:
    The NHS screwing someone over again?

    In what way are they screwing her over?

    Just a thought, which you may not have, but the same £21k could be spent on providing a nurse to treat Lymhpoedema patients. These people will ultimately end up in a wheelchair. The success rate for nurse treatment is nearly 100% and yet the NHS doesn't invest in this service much. A single nurse could treat over 300 patients in a year.

    Which do you think is the better spend? Is it better to "screw one person over" or 300?

    Those are the choices which some of us have to make.
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    Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    Not really, the efficacy of the drug is still in question. It costs £21k for one person to be treated for a year. Based on the current success rate, the NHS will have to spend £500k just to get a single success.



    In what way are they screwing her over?

    Because its going to be licenced soon and other areas have allowed its use.
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    Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    minimi38 wrote:
    Because its going to be licenced soon and other areas have allowed its use.

    It might get licenced, but even then the PCT is under no obligation to provide it for everyone who asks for it.

    The issue of "value for money" is still paramount because the PCT has an obligation to ensure that the needs of the majority are not outweighed by the needs of an individual.

    BTW You didn't answer the question about who is really egtting screwed over here. And I didn't even mentioned the cost to the PCT of defending their decision in court - how many treatments will be prevented because of that?
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    Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    In many other countries, Herceptin is already being made available for early-stage breast cancer without a licence. In Germany, France, Spain, the Netherlands, Slovenia, the US and four provinces in Canada, Herceptin is being prescribed before being licensed.

    If Slovenia can stump the cash up to provide the drug then why can't the NHS...
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    Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    minimi38 wrote:
    If Slovenia can stump the cash up to provide the drug then why can't the NHS...
    There are two aspects here:

    1. It is unlicensed in the UK
    2. Money could be fairer spent elsewhere

    Licenses are there for a reason. Primarily to protect us all from possibly harmful drugs. The licensing laws are strict for a reason. Do you remember the drug Thalidomide? It caused birth defects in 10 000 children worldwide. But since then licensing laws have been made tighter because we learn from our mistakes (Thalidomide was never sold in the USA as there were doubts of its safety). The license thing is issued after stringent testing which Herceptin is still undergoing.

    Scare resources. Maybe Slovenians pay more tax? Or spend less in other areas? You can't just pretend that the NHS has as much money as they fancy having. They need to allocate resources fairly.

    I'm not just saying this to be harsh either. My mother had breast cancer at 42 and my grandmother died of the disease when she was only 46.
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    Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    When the manufactuer Roche applies to the European court to have it licensed for early stage cancer sufferers the drug's license will be will be fast tracked, accoding to an article i have read about the issue. So it being licensed is only a matter of time. Those coutries provide it to all that need it before it has been licensed because they recognise it is an effective treatment. In some areas it is being provided to people and others it isn't simply because it is not licensed yet. ManofKent brought up the issue of the moneyt being used for something else, a "thought i might not have" ( :rolleyes: ) which is irrelevent considering the health secretary told NHS trusts not to withold the drug on financial grounds. It is all just a bureacratic mess.
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    Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    minimi38 wrote:
    In some areas it is being provided to people and others it isn't simply because it is not licensed yet.
    What do you mean by simply because its not licensed yet? I'd say that's a good reason not to supply a medication.
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    Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    When the manufactuer Roche applies to the European court to have it licensed for early stage cancer sufferers the drug's license will be will be fast tracked, accoding to an article i have read about the issue. So it being licensed is only a matter of time. Those coutries provide it to all that need it before it has been licensed because they recognise it is an effective treatment. In some areas it is being provided to people and others it isn't simply because it is not licensed yet.

    ...
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    Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    I forgot to add that the drug hasnt been licensed becuase the firm hasnt yet applied for the licensing!
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    Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    minimi38 wrote:
    I forgot to add that the drug hasnt been licensed becuase the firm hasnt yet applied for the licensing!
    Don't you find yourself asking why that is?

    It is in the drugs company's best interest to get it licensed as soon as they can so there must be a reason they aren't ready yet :chin:
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    Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    It is in the drugs company's best interest to get it licensed as soon as they can so there must be a reason they aren't ready yet :chin:

    Lot of free publicity going around at the moment, isn't there?
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    Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    minimi38 wrote:
    So it being licensed is only a matter of time.

    Still not relevant. The NICE acceptance is though. NICE may still say that it isn't financially worthwhile. Even then they will only provide "guidance" which doesn't have to be followed.
    ManofKent brought up the issue of the moneyt being used for something else, a "thought i might not have" ( :rolleyes: ) which is irrelevent considering the health secretary told NHS trusts not to withold the drug on financial grounds.

    She also told them to balance their books. She also said that only people diagnosed after 5th October should even be considered (why that date, surely that's just arbitary?), she also said that more people should be treated in community hospitals, that GPs should be paid more (ditto nurses), that people shouldn't wait for surgery, or for MRIs, CT scans, X-Rays etc.
    It is all just a bureacratic mess.

    Except it isn't. It's a political mess, it's a media mess. From an NHS point of view it's fairly straight forward. The drug isn't licenced, there are other treatments - proven to work - which need funding and so there really isn't a debate. Weonly have so much money to spend. personally I'd rather treat 300 people, than just one.

    Why is that so hard to accept?

    Other than the fact that breast cancer is a "sexy" story for the tabloids.
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    Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    This treatment is too expensive. Whether the drug is licensed or not seems almost irrelevant when it'll cost 21k for one year and one patient, and 500k a year for one success. Forgive my cynacism, but I'd rather have a macmillan nurse.
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    Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    Fiend_85 wrote:
    Forgive my cynacism, but I'd rather have a macmillan nurse.

    Who isn't funded by the NHS for the first three years...

    Another reason to drop a couple of quid in the Macmillan collection box if you ask me.
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    Former MemberFormer Member Posts: 1,876,323 The Mix Honorary Guru
    I remember my mum's macmillan nurse, it's one of the very very very few nice things I remember about my childhood. Though what I remember isn't all that pleasant, she was making up my mums medication for the day and telling me what went in and what it did. I don't remember anything she said though, just that she didn't mind me being there and explaining.
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