Not another magic bullet

Medical breakthroughs are rare, but the new breast cancer drug trastuzumab (Herceptin) was launched yesterday with all the buzz words we associate with a genuine breakthrough: “magic bullet,” “Holy Grail of cancer treatment,” “fast-tracked by US licensing authorities,” and, best of all, “free of side effects.” Even the cancer it treats has a high media profile.

When a public relations company asked me to a press briefing in Milan to hear about this new drug, I hesitated. As a journalist, it is my job to search out news, and the launch of any drug that targets tumour cells while leaving healthy cells unscathed must surely be important. I also know how hungry patients are for any good news at all; as a former cancer patient I am anxious not to build up false hopes, but nor do I wish to withhold valuable information. The real question is, should you tell people about a drug that they probably can't have?

Public relations companies provide vast amounts of information about new drugs, but they don't tell you the cost unless you make a point of asking. A 34 week course of trastuzumab costs £12 000, but this is just the starting price. Most of the evidence for its effectiveness comes from trials that combine it with other high cost drugs, such as the …