North Stoke Primary Care Trust has backtracked on its decision not to prescribe Roche’s breast cancer drug Herceptin (trastuzumab) to UK woman Elaine Barber, in what has been hailed as a victory for patient rights.

But the decision has also been greeted with dismay by PCT executives, who say the volte face – prompted by the intervention of Health Secretary Patricia Hewitt - has placed the National Health Service in a no-win situation, according to a BBC News Online report.

Barber had threatened to take North Stoke PCT to the High Court in the case [[09/11/05b]], but will now receive treatment with Herceptin even though, as a patient with early-stage breast cancer who is currently in remission, she does not match the profile for treatment. At present, Herceptin is only approved for use in patients with advanced-stage disease, although clinical trials have suggested that it is an effective treatment for early-stage patients [[14/09/05d]]. However, an editorial in The Lancet this week has called that into question, saying: “The best that can be said about Herceptin’s efficacy and safety for the treatment of early breast cancer is that the available evidence is insufficient to make reliable judgements.”

PCTs say they will now be unable to refuse treatment with Herceptin, even though this is discretionary and will remain so until the drug is approved for use outside advanced disease and has undergone review by the National Institute for Health and Clinical Excellence (NICE).

North Stoke PCT said it granted Barber the right to receive the drug because of her

“particular exceptional circumstances.” Other women with breast cancer in the North Staffordshire region governed by the Trust said they would also now press for access to Herceptin.

Last month, former nurse Barbara Clark won a legal battle to be given Herceptin after she threatened to use the Human Rights Act to force her PCT to prescribe the drug [[04/10/05c]].

However, the country’s NHS Confederation, which represents more than 90% of NHS organisations said: “PCTs now find themselves placed under huge public pressure if they d not prescribe Herceptin for use in early-stage breast cancer on the grounds of safety and cost-effectiveness. We are concerned that PCTs are being put in an almost impossible position by growing pressure to bypass systems established to protect patients.”