Breast cancer patients living in Wales are getting the so-called "wonder drug" Herceptin free at a hospital but women living in England have to pay, it emerged yesterday.
The "postcode lottery" surrounding the potentially life-saving drug means that women in Wales do not have to pay for the treatment at the Royal Shrewsbury hospital because Herceptin provision is funded by their health board. But women in the early stages of breast cancer who live in England must raise the £30,000 a year cost themselves, because their primary care trust will not foot the bill.
The disparity - which illustrates the differences in priorities between different PCTs - was exposed yesterday by Owen Paterson, the North Shropshire Tory MP.
Since February, all Welsh local health boards have agreed to pay for the drug for women living in Wales who need it, even if they are treated in England.
But, in England, its use is largely restricted to patients in an advanced stage of the illness because the drug is still to be approved for early use by the National Institute for Health and Clinical Excellence (Nice), the body that determines the cost effectiveness and efficacy of treatment. Nice is expected to make a decision later in the year.
Last October Patricia Hewitt, the health secretary, said health trusts should not turn down Herceptin on the basis of cost alone. But the trusts are not obliged to follow this suggestion and, with a year's supply costing almost £30,000, many are waiting for Nice's guidance.
Mr Paterson said this had led to "a classic postcode lottery" at the Royal Shrewsbury because English women were not getting the same treatment as their Welsh neighbours.
"All these women in Shropshire have paid their taxes but they have had to raise huge sums of money while women two miles away in Wales are getting the drug in the same hospital for free," he said. "It's wrong that if you live the wrong side of the border you don't get the same drug."
No one from the Royal Shrewsbury or the Shropshire county primary care trust was available for comment.
But a spokeswoman for Shropshire and Staffordshire strategic health authority said: "The routine use of Herceptin will be introduced when and if Nice guidance is published. However, a clinician may ask a PCT to approve the use of Herceptin in exceptional personal circumstances.
"As the drug is yet to be licensed or approved by Nice, the NHS across the West Midlands is not proposing to support the routine use of Herceptin in women with early breast cancer.
"Nice guidance will only be published after the regulatory authority licenses use in early breast cancer.
Herceptin works by targeting the HER-2 protein, which can fuel the growth of breast cancers, and stopping this process happening. But it only works on the 20% of breast cancers that are HER-2 positive.
It has been hailed as a "wonder drug" because it was claimed it halved the chances of the aggressive HER-2 form of breast cancer returning. In reality, the 50% reduction is relative, with 9.4% of women on the British trial finding their cancer returned compared with 17.2% who did not have the drug. There are also concerns that it may be linked to heart problems. But that has not prevented a number of breast cancer patients taking to the courts to gain treatment.
