Access to medicines, especially new cancer drugs, is a highly emotional issue. The furore over the breast cancer drug Herceptin (trastuzumab) was huge. It was licensed in 2002 for advanced cancer in the 20% of patients with the form called Her2 positive. In 2006 it was fast-tracked to a licence for women with an early stage of the cancer in response to a public campaign.
The drug cost £20,000 a year at the time, causing primary care trusts to think twice before agreeing to pay for it, especially as Nice had not yet ruled on whether it was value for money. But newspapers ran stories of women prepared to sell their homes to get it – one, Ann Marie Rogers, went to court to demand her primary care trust fund it and won, saying she faced a death sentence without it. She died of her breast cancer three years later.
Herceptin is still expensive, because there is not yet a cheap biosimilar version. And now it is being prescribed with a drug for advanced Her2 positive cancer called Perjeta (pertuzumab), which has a list price of £4,790 for the first dose and £2,395 for each dose thereafter - and which should be given every three weeks until the cancer returns, at around £46,000 a year, although the manufacturer has offered the NHS a discount.