Dear Colleague,

New Year greetings from historic Bury St Edmunds in the east of England.

Some of you might recall the Herceptin saga that attracted a lot of 
attention in the UK in recent times. Now it appears we might have another 
Herceptin on the horizon.

On December 29, the NEJM published a study which compared letrozole with 
tamoxifen as adjuvant treatment for steroid-hormone-receptor–positive breast 
cancer in postmenopausal women. The study concluded that “In postmenopausal 
women with endocrine-responsive breast cancer, adjuvant treatment with 
letrozole, as compared with tamoxifen, reduced the risk of recurrent 
disease, especially at distant sites”. Abstract available on line @
http://content.nejm.org/cgi/content/abstract/353/26/2747

I found the press coverage on this quite interesting. According to the 
Guardian dated 29th December
“…..These are among issues that will be considered by advisers to the NHS in 
England and Wales, who must determine the effectiveness and value-for-money 
of the new drugs. Their verdict is expected in November next year, but the 
flood of good news from trials involving the aromatase inhibitors may lead 
to pressure on doctors to prescribe them, and local health trusts to fund 
them, in the way that there have been calls to fund Herceptin, a drug aimed 
at a different and particularly aggressive form of breast cancer”. Guardian 
coverage @
http://www.guardian.co.uk/medicine/story/0,11381,1674585,00.html

The press release from Novartis on the drug receiving US approval as initial 
therapy for postmenopausal women with early breast cancer after surgery 
available @
http://www.pharma.us.novartis.com/newsroom/pressReleases/releaseDetail.jsp?PRID=1944

We are all well aware that scientific advances do create huge pressures on 
the health care budgets of publicly funded health systems and I wonder 
whether we have another Herceptin on our hands. However as PH practitioners 
I feel our duty is to balance the competing priorities on the limited health 
care budget that is available and try hard to maximise the health gain for 
the whole population.

Warm regards & very best wishes,

Badri


Dr.P.Badrinath  MD, BS, M.Phil, MPH, PhD (Cantab), MFPH
Consultant in Public Health & Affiliated Clinical Lecturer,
Suffolk West PCT & University of Cambridge, UK
http://myprofile.cos.com/badrishanthi

Disclaimer: The above views are my own and not that of my employing 
organisations.