Doctors writing in The Lancet have raised questions over the expense of Roche’s Herceptin for patients with stomach cancer given the magnitude of its survival benefit.

Data from an open-label, multi-national, randomised, controlled Phase III trial published in the journal showed that a combination of chemotherapy and Herceptin (trastuzumab) boosted the survival of patients with advanced gastric cancer from 11.1 months to 13.8 months.

The researchers concluded that, on the basis of these results, the combination “can be considered as a new standard option for patients with HER2-positive advanced gastric or gastro-oesophageal junction cancer”.

But in an accompanying article, Professor Alastair Munro and Dr Paddy Niblock, from the department of surgery and molecular oncology at Ninewells Hospital and Dundee University Medical School, UK, have questioned the affordability of the drug.

Calculating the cost per life-year gained to be around £55,000 pounds, the doctors ask: “In the 24 countries that contributed to the study, yearly health expenditure per citizen varies from $40 to $5,500, which reiterates the important moral question – what is the justification for introducing a treatment that might enable one individual to live a few months longer, but will consume, for each person treated, the total yearly health expenditure for scores of their fellow citizens?”

Back in July, the UK’s cost-effectiveness watchdog the National Institute for Health and Clinical Excellence published draft guidance rejecting the drug’s use in this setting.

Explaining its decision, the Institute said it felt there were still too many uncertainties surrounding the magnitude of Herceptin’s effect, and that this, coupled with its price tag - estimated to be around £10,185 per patient based on a weight of 62kg - meant it was unable to conclude that the drug would be a cost-effective use of resources.