A new treatment for lung cancer can be given to Scots on the NHS, but a new breast cancer drug will not routinely be made available to patients north of the border.
The body which approves treatments for the NHS in Scotland has accepted the drug crizotinib, which could be an alternative to chemotherapy for some lung cancer patients.
The decision, by the Scottish Medicines Consortium (SMC), means Scotland is currently the only part of the UK so far to approve the drug for use on the NHS.
But at the same time the SMC has ruled that a new breast cancer drug – Perjeta – will not be recommended for use.
Drugs manufacturer Roche branded that decision an “injustice for patients in Scotland”.
The firm said patients with the HER2 positive breast cancer taking Perjeta lived on average just over six months longer without their disease getting worse than those treated with Herceptin or chemotherapy alone.
About 4,100 women in Scotland are diagnosed with breast cancer every year, with up to a quarter of them having the HER2 positive form of the disease.
Jayson Dallas, general manager of Roche Products, said: “Perjeta represents a major advance in the treatment of HER2-positive breast cancer, so the decision to deny access to this treatment is an injustice for patients in Scotland.
“Access to effective cancer medicines in Scotland is now a pressing issue – and one that the Scottish Government and the SMC must urgently address.
“The current system simply doesn’t work for cancer and the announcement last week that the Cancer Drugs Fund in England will be extended highlights the widening gap of cancer care between England and Scotland.”
Cancer patients in England can obtain treatments that have not been approved for general use on the NHS using the Cancer Drugs Fund, but no such scheme exists in Scotland.
While the SMC is not recommending Perjeta, it has accepted crizotinib for use on the NHS for those patients with ALK positive advanced non small cell lung cancer.
Dr Marianne Nicolson, consultant medical oncologist at Aberdeen Royal Infirmary, said: “This important decision is great news for lung cancer patients in Scotland, where rates of lung cancer are among the highest in Europe and outcomes are typically very poor.
“Crizotinib gives selected patients precious extra months with loved ones and also helps to provide these patients with a better quality of life.”
On average, more than 5,000 cases of lung cancer are diagnosed each year in Scotland, with 4,000 people dying from the disease on an annual basis.
In 2011 there were more than 2,500 reported cases of non small cell lung cancer and Dr Nicolson said the SMC decision meant the test for the ALK abnormality should be made available to these patients “in order to define more accurately their illness and identify targeted and effective treatment options”.
Dr David Montgomery, medical director of Pfizer Oncology UK, said it was “encouraging to see the Scottish Medicines Consortium adopt a more progressive and effective approach to assessing the cost effectiveness of crizotinib and making the treatment available to patients”.
He added: “Historically, access to cancer medicines has been a challenge in Scotland but this decision is a positive step towards ensuring that cancer diagnosis and treatments are more targeted to specific cancer types.”
The SMC said it had accepted crizotinib for use because “it was considered to offer value for money”.
But it said this was “contingent upon the continuing availability” of a patient access scheme, which means the drugs are made available at a discounted price.
However, it said it did not recommend Perjeta – which is also known as pertuzumab – “because the medicine was not considered to offer value for money”.
James Jopling, Breakthrough Breast Cancer’s director for Scotland, said the decision was “hugely disappointing” as the treatment was “shown to be very effective at giving women with secondary breast cancer the benefit of more good quality time with their families as they approach the end of their lives”.
He added: “Women with secondary breast cancer already have severely limited treatment options.
“This decision should serve as a timely reminder to the Scottish Government – who this week will be announcing their recommendations to improve access to treatments – that they must take account of the wider value of medicines, particularly those which are innovative and those intended for people approaching the end of life.”