Table Box 1.

 Examples of claim categories

Trastuzumab confers clinical benefit(s)

‘Herceptin is proving incredibly effective in fighting this disease’ (Doctors hail breast cancer drug trial, The Times, 14 May 2005).

There is uncertainty about clinical benefit(s)

The ability of the treatment to reduce the death rate can’t yet be analysed as the trial hasn’t continued long enough to make the results statistically significant. (A drug right on target, The Times, 19 May 2005).

Trastuzumab causes clinical harm(s)

However, according to the Herceptin website ‘administration can result in the development of certain heart problems, including congestive heart failure’. (Cancer drug delivers hope – and £2.5 billion, Observer, 23 October 2005).

There is uncertainty about clinical harm(s)

But [the Department of Health] pointed out that more data was needed to prove that Herceptin was safe. (A victory for the patient, Express, 4 October 2005).

Trastuzumab is expensive

She said a consultant in Bristol offered Herceptin for £1600 per dose to private patients, with a year’s treatment costing pounds £27 000. (Mum sells home to fund vital treatment, Birmingham Post, 9 June 2005).

There would be an opportunity cost to funding trastuzumab

Laura Butcher of the International Myeloma Foundation said: ‘Some PCTs say we have no money for other drugs because Herceptin has been made a priority’. (Cancer Drug Confusion, Express on Sunday, 19 February 2006).

Not funding trastuzumab is the opportunity cost of waste/treating the unworthy

If healthcare rationing must take place, then it should be to stop some of the unnecessary operations such as tattoo removal or sex change operations. (Deadly unfair healthcare, Express, 23 September 2005).

Private and foreign insurance systems fund trastuzumab

‘There are private patients in the early stages of cancer who are getting it in this country privately and it is also being used in this way in Canada, America, France and Germany without any known side‐effects’. (The wonder drug, Express on Sunday, 24 July 2007).

Private and foreign insurance systems may not fund trastuzumab

The refusal of Axa PPP Healthcare to pay for the drug Herceptin for women with early stage breast cancer beggars belief. (They’re playing with lives, Daily Mail, 05 October 2005).

Access to trastuzumab is a right

Miss Clark … claims that the NHS is denying her the ‘right to life’.

Access to trastuzumab is not a right

Yesterday Mr Justice Bean found that Swindon’s PCT’s policy was not unlawful, either in English law or under the European Court of Human Rights.