Adjuvant trastuzumab for breast cancer: The other side of the coin

doi:10.1136/bmj.331.7526.1202-c

BMJ 2005;331:1202-1203 (19 November), doi:10.1136/bmj.331.7526.1202-c

Letter

Adjuvant trastuzumab for breast cancer

The other side of the coin

The first 150 words of the full text of this article appear below.

EDITOR—The editorial by Dent and Clemons in the middleof media frenzy about the use of trastuzumab was appropriate.¹As suggested, equity of access to such novel and expensive treatmentsshould be through well designed funding processes. In calculatingthe cost of treatment, the overall cost of the drug, its administrationcost, the cost of related investigations, and the opportunitycost should be taken into account. Assuming that 25% of patientswill be suitable for trastuzumab treatment, the overall costof treatment in the UK will be over £200m (based on thecancer incidence figures for 2003²). This could otherwise havebeen invested in breast cancer research or prevention or earlydetection programmes, which will prevent recurring cost of treatmentin future.

In analysing the number needed to treat (NNT) in the HERA trial,³we found that 19 patients need to be treated to prevent onerecurrence. . . . [Full text of this article]

Somasundari Gopalakrishnan, honorary fellow

somla@tiscali.co.uk
Walsall Teaching Primary Care Trust, Walsall WS1 1TE

John Linnane, deputy director of public health

Walsall Teaching Primary Care Trust, Walsall WS1 1TE