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Radio 4: Leading cancer specialist questions cost-effectiveness of Herceptin
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One of the UK's leading cancer specialists has questioned the cost-effectiveness of breast cancer drug Herceptin, in an interview with 91Èȱ¬ Radio 4's The Investigation.
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Dr Peter Kirkbride, of the National Clinical Lead for Radiotherapy, told the programme that the NHS spent £100m Herceptin in 2006, giving the drug to around 5,000 patients with breast cancer.
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However, he thought it had only made a difference to about 500 of those patients – costing an estimated £200,000 per patient.
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Dr Kirkbride said: "There's a lot of publicity about the role of chemotherapy but the consensus is, of all cancers that are cured, half are cured by surgeries, 40% by radiotherapy and only 10% by drugs (chemotherapy)."
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If the £100m Herceptin budget was to be spent on radiotherapy, Dr Kirkbride said:
"If I was to spend £100m on radiotherapy, I could buy something like 90 machines, I could buy 30 simulators and I could probably benefit about 30,000 patients for the same amount of money."
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In 2006, the National Institute for Health and Clinical Excellence (NICE) approved the use of the drug Herceptin for women with early stage breast cancer on the NHS, after its appraisal was fast-tracked.
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But now some cancer doctors, including Dr Kirkbride, are concerned that this focus on new cancer drugs has been at the expense of other forms of treatment.
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The National Cancer Director, Mike Richards, says there should be room in the cancer budget for both kinds of treatment.
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He told the programme: "There is no doubt that Herceptin is a good drug. There is no doubt that it has been looked at carefully by NICE and it has been deemed to be both effective and cost effective."
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And he said: "Radiotherapy is also effective and we need to make sure that it's not one or the other, but that we actually have a service that delivers both."
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Earlier this year, the National Radiotherapy Advisory Group published a report which called for a 91% increase in radiotherapy treatments in England in the next ten years.
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But the trade body for the manufacturers of radiotherapy machines has told the 91Èȱ¬ that, instead of seeing more business, it has all but dried up.
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David Miles, chairman of the radiotherapy specialist focus group of the Association of X-Ray Equipment Manufacturers, formed to highlight the problem, says there has been a "collapse in critical investment."
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He also said:
"We noticed after the Government initiatives to improve the established stock of radiotherapy equipment, it actually ended in April last year. And the sales of machines then fell off drastically."
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And that: "One order's been placed in the last 20 months."
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It takes around three years from when a machine order is placed until it can treat its first patient and the radiotherapy focus group at the Association of X-Ray Equipment Manufacturers says therefore the NHS should have bought 20 replacements machines by now, instead of just one.
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On this point National Cancer Director, Mike Richards, said: "We have made it very clear through the radiotherapy report that at the local level people do need to be planning ahead... it is important to remember that we've put in place a large number of new ones over the last few years and so those ones are not yet due for replacement but you're right, we need to make sure there is a replacement programme in every part of the country."
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Dr Peter Kirkbride thinks part of the problem is the discipline's profile in the eyes of both the public and Government.
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He said: "We're not sexy enough. We don't have pharmaceutical companies backing us in the same way that some of the drugs companies support campaigns for the use of their drugs."
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91Èȱ¬ Radio 4's The Investigation: The Sick Man Of Europe looks at cancer services in the UK and is broadcast at 8pm on Thursday 29 November 2007.
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Listen to the programme again online post-broadcast at bbc.co.uk/radio4 or download the podcast at bbc.co.uk/podcasts.
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