Cancer is a Government priority. However, decisions on the provision and funding of cancer services are a matter for the national health service and individual primary care trusts to consider as part of their local priority setting.
In the ‘NHS Cancer Plan’, published in 2000, the Department confirmed its commitment to increasing investment in cancer research and breast cancer trials constitute the largest proportion of trials in the national cancer research network’s portfolio.
In 2004-05, £3.8 billion was spent on cancer services. However, figures are not routinely collected centrally on the treatment of individual cancers, including inflammatory breast cancer.
It is for individual clinicians, in discussion with a patient, to decide whether or not it is suitable to prescribe a specific drug, taking into account any relevant guidance from the National Institute for Health and Clinical Excellence (NICE). Primary care trusts may need to be involved to decide whether to support the clinician's decision and supply the drug at the national health service expense.
On 9 June 2006, NICE published its draft guidance on Herceptin. This recommends the drug for women with early stage HER2-positive breast cancer, except where there are concerns about cardiac function.
However, there may be other individual patients for whom it is not suitable—for example, if the woman is too frail to tolerate chemotherapy. This will be a matter for discussion between a woman and her clinician.
These recommendations are subject to an appeal period which closed on 28 June 2006. Final guidance is expected to be issued at the beginning of July, assuming there are no appeals. There are no national restrictions on the NHS using Herceptin in the interim.