Abstract
Dr Atkins 1 defends the usual practice of pharmaceutical companies of underestimating the costs of the administration of their products in the media (JRSM 2007;100:303). As we all know, the NHS has great difficulty in working out the true cost of any component of care as its accounting and IT systems are primitive. My figures 2 were obtained simply by determining the costs to a self-pay private patient in London over a one-year period. These costs are actually very similar in the private sector and NHS. As most patients obtain non-NICE approved cancer drugs outside the NHS, this seems the fairest way to make the calculation.
I would strongly dispute Dr Atkins’ claim that the non-drug costs to administer adjuvant trastuzumab—which requires at least 30 visits a year for intravenous drug administration by skilled nurses, cardiac monitoring, side effect management, disease assessment and consultant supervision—amount to only £3,580. Medical care just doesn't come that cheap, even in the NHS. In an era when patients are now having to pay supplements for innovative drugs for cancer it is vital that we make the total cost of exercising this choice crystal clear.
Competing interests None declared