Doctors hit out as Scots patients are denied new stomach cancer drug

Published on Monday 9 August 2010 18:26

THE decision to deny patients with stomach cancer in Scotland access to a new drug to treat the disease has been criticised by medics and campaigners.

The Scottish Medicines Consortium (SMC) said it could not recommend Herceptin - also known as trastuzumab - for use on the NHS because its cost outweighed the benefits.

One doctor yesterday described the decision as "disappointing", while patients' campaigners called for the treatment to be made available for the small number of people each year who would benefit.

Herceptin is now widely used in patients with breast cancers which test positive for the protein known as Her-2, having initially been denied to some by drugs watchdogs.

The drug, which costs around 10,000 for a six-month course, has been shown to be effective against stomach cancers which are also Her-2 positive.

Manufacturer Roche estimated that about 50 patients a year with Her-2 positive advanced stomach cancer in Scotland could benefit from the treatment, out of about 730 people with the disease.

The company said a trial had found that when Herceptin was added to chemotherapy, it increased patients' overall survival by four months, from 11.8 months to 16 months.

But yesterday the SMC said it could not currently recommend the treatment for use by the health service.

"SMC did not accept trastuzumab for use in NHS Scotland because the treatment's cost outweighed its health benefits and there were a number of uncertainties in the manufacturer's economic case which meant that the drug was not considered to be value for money," it said.

Roche said it was now clarifying some of these uncertainties, as well as providing more evidence of the drug's benefits, and would resubmit the treatment to the SMC.

Dr Russell Petty, a consultant and senior lecturer in medical oncology at Aberdeen University, said drugs such as Herceptin provided a targeted treatment which had the best chances of being successful for patients. He added: "It is disappointing that we can't offer a breakthrough treatment like this to patients."

Margaret Watt, chair of the Scotland Patients Association, said it was "morally wrong" to withhold treatments.

Case study: 'When diagnosed you really are looking for any positive sign'

For cancer patient John Barclay, the idea that he could have been denied a treatment to extend his life is almost unthinkable.

The 63-year-old from Aberdeen was diagnosed with stomach cancer in June 2008 and went on to have chemotherapy and surgery to treat the disease.

"I had an upset stomach for four or five months and it was initially put down to irritable bowel syndrome," Mr Barclay said. After first having chemotherapy to shrink the tumour, the HR manager had radical surgery to remove his stomach in January 2009.

This was followed by a nine-week course of chemotherapy, before he was eventually given the all-clear last summer.

Mr Barclay said he had quickly been able to adapt to eating "little and often" to cope with the lack of a stomach and he was now well.

"When they told me the cancer had gone it was a big relief," he said.

"You always have to take account of the fact that you have had it and it has been in your system, but it is uplifting to get that result."

Mr Barclay said it would be a "terrific blow" to patients who were told there was a drug that could help them but that the NHS would not pay for it.

He said: "When you have been diagnosed with cancer you really are looking for any positive sign you can – anything that can give you more strength to fight it because part of it is how you deal with it yourself. "You are looking for a chance of getting some armoury to fight the disease with."

Mr Barclay added that patients' families would also suffer as a result of denying treatments.

He said in the case of Herceptin, trials had shown it helped extend people's lives.

He added: "I can understand there is a dilemma there (over cost], but it is very difficult for a cancer sufferer to talk about case balances when you are staring your mortality in the face."