Decision on key breast cancer test delayed

THE final decision on whether public patients will be able to access a breast cancer test that could save up to 500 women from having to endure chemotherapy every 12 months is not expected until towards the end of this year.

Sources close to the evaluation process have confirmed that the National Cancer Control Platform (NCCP) will not make a decision until patient care and clinical reports, among others, are concluded.

These aspects of the ongoing review process will be included with that of the National Centre for Pharmacoeconomics, which over the weekend confirmed it is not recommending the test’s use in the public system due to the high cost involved.

This decision has led to an outcry from members of the public and cancer patient support groups over the potential placing of budgetary needs before patient care.

The issue surrounds the availability of the Oncotype DX test, which is currently only used for private patients.

When used on breast cancer sufferers, the test can check if tumours are confined to the breast or have spread to the lymph nodes in the armpit and whether tumours are linked to oestrogen levels.

If the test comes back “lymph node negative”, the patient can be treated without the need for debilitating chemotherapy doses.

Similarly, the oestrogen part of the test allows doctors to make a decision on whether the cancerous growth can be treated via hormone blockers and surgery — a less debilitating approach.

The National Centre for Pharmacoeconomics has confirmed that “based on the submitted price” of €3,200 per patient, as put forward by the test’s makers Genome Health Ireland, the Health Service Executive will not be able to offer it to public patients.

However, the NCCP has stressed that this recommendation will form only part of the overall decision due later this year, with negotiations with the company expected in the near future.

Speaking on RTÉ radio’s Morning Ireland programme yesterday, Dr Cathy Kelly, a consultant medical oncologist at the Mater Hospital in Dublin, said the test “is very important and should be available for all patients”.

She said “some negotiation in terms of cost” is currently taking place between the NCCP and the company behind the test, and that she is “confident” the breakthrough “will be available for [public] breast cancer patients”.

When asked about the possibility of the test not being available in the public system, Dr Kelly added: “That would be a situation that shouldn’t be allowed to happen, and I really am confident that it won’t happen. It is extremely valuable and extremely helpful.”

A spokesman for the NCCP said the value of the test is still being examined as part of a “comprehensive” review involving financial, patient care and clinical aspects of the treatment.

If the test is provided within the public health service, it would be of use to an estimated 400-500 of the 2,800 women who on average develop breast cancer in Ireland every year.

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