Adjuvant trastuzumab for breast cancer: Editorial does not mention health economics of drug

doi:10.1136/bmj.331.7526.1203

BMJ 2005;331:1203 (19 November), doi:10.1136/bmj.331.7526.1203

Letter

Adjuvant trastuzumab for breast cancer

Editorial does not mention health economics of drug

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

EDITOR—Why does the BMJ, which promotes itself as a journaldedicated to evidence based medicine, publish an editorial thattalks only of the hazard ratio of a treatment without any referenceto the absolute reduction in recurrence observed?¹

From the original paper I calculate the absolute reduction inrecurrence rate at one year with trastuzumab to be 5.5%,² givinga number needed to treat of 18 (rather than the 13 mentionedby Grove [letter in this cluster]).

There was no reduction in total mortality (no "lives saved"),but this might be due to the limited follow-up.

Although the exact figures may change with further experiencethis means, at present, that of 100 suitable patients giventhe drug for a year, 94 will have been exposed to the (not insignificant)side effects without any effect on their outcome at one yearand the taxpayer (in the United Kingdom) . . . [Full text of this article]

E Hamish McLaren, retired consultant physician

Badmany House, Beith, Ayrshire KA15 2JL handsmclaren@btinternet.com

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