Herceptin results beg questions on equal access to expensive drugs

The recent press coverage on the use of Herceptin (brand name for the drug trastuzumab) for treating breast cancer in its early stages shows that issues of equal access to costly but effective drugs must be confronted, says an editorial in the British Medical Journal.

Trastuzumab was "rapidly adopted as the standard of care" in the US for treating breast cancer, but one of the barriers to its use in other countries is its high cost, say the authors. In Canada the treatment costs $C50,000 a year (£25,000) per patient, and despite its effectiveness was not approved for funding in Ontario until after a media backlash.

The drug represents the first of probably many new cancer treatments of this kind, say the authors. The new hope it gives to patients also highlights new cost issues - both for the drugs themselves and surrounding cost of treatment.

Equality of patient access must extend to these accompanying areas, for example in diagnosing suitability for the drugs. Recent UK figures, for instance, show that only half of women are currently tested for the cancer gene targeted by the new treatment.

Healthcare systems around the world must no longer be left scrambling when effective new treatments come on the market. Transparent, timely and appropriately funded processes must be in place if patients are to get equal access to the best new treatments, conclude the authors.

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