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The high cost of treating British cancer patients with expensive drugs such as Herceptin could mean hospitals will have to cut treatment for other patients if no extra funding is available, doctors say.
Hospitals in England and Wales were told this year they should offer Herceptin to suitable patients in the early stage of the disease. But the drug's high cost - £20,000 ($57,988) a patient a year - means cuts may have to be made elsewhere, the doctors wrote in the British Medical Journal.
Health Minister Rosie Winterton dismissed the doctors' concerns.
Cancer doctors Ann Barrett, Tom Roques and Matthew Small from the Norfolk and Norwich University Hospital NHS Trust said the medicines cost-effectiveness watchdog NICE, which approved Herceptin in August for NHS use, should also say what should be cut to fund it.
The move followed high-profile legal battles by women with early stage breast cancer to force their local health authorities to pay for the drug.
The doctors estimated they would have to find £1.9 million a year - rising to £2.3 million after testing and monitoring - to give Herceptin to 75 patients.
But with limited budgets, funding Herceptin might mean cutting post-surgery treatment to 355 other cancer patients, of whom 16 would be cured, or 208 patients getting palliative chemotherapy.
"These untreated patients will be people we know," the doctors wrote. "We will be the ones to tell them they are not getting treatment that has been proved to be effective and which costs relatively little, because it is not the treatment of the moment."
"Doctors treat patients according to their clinical need. Primary Care Trusts should always be planning ahead and we would expect them to consider the implications of introducing all drugs on the horizon, not just Herceptin."
Barbara Clark, a Somerset nurse who won a legal fight for Herceptin treatment last year, said cancer patients were not to blame for the NHS' financial problems. "It's dreadful they are blaming women who have a particularly deadly cancer for the state of the health service - pitting patient group against patient group," she said.
- REUTERS
