The Women Denied a Life Saving Drug; MoneyMail

Daily Mail (London), October 19, 2005 | Go to article overview

The Women Denied a Life Saving Drug; MoneyMail


Byline: LIZ PHILLIPS

MEDICAL insurers are condemning women with breast cancer to die by refusing to pay for groundbreaking treatment. This is the opinion of top cancer specialist Dr Maurice Slevin.

Insurers, such as Axa PPP Healthcare and Legal & General, are claiming that the cost of miracle drug Herceptin is not covered in some cases by their medical policies as it is regarded as 'preventative or long-term treatment'.

Money Mail reader Liz Fahey, 50, from Bristol, was told by her insurer Legal & General it would pay for Herceptin only if her breast cancer returned. She has tested positive for HER2, a chemical which is present in a quarter of breast cancer patients, which shows she has the most aggressive form of the cancer.

But oncologist Dr Slevin, chairman of charity Cancer BACUP, says: 'When the cancer comes back in the cases of women with HER2 they can no longer be cured.

Herceptin can only prolong life at that stage. The only chance of being cured is to use Herceptin upfront.

'These insurers are condemning people to die. It's ridiculous to call it preventative treatment. You could be curing people who would otherwise die of cancer.' Herceptin is expensive. It can cost as much as [pounds sterling]26,000 for a year's treatment, which is the length of time recommended by doctors.

Mrs Fahey, who is married with two sons, says: 'The thought of the cancer coming back fills me with dread and fear. I have the most aggressive kind of cancer which is two-and-a-half times more likely to come back during the next two to three years.

'You can't hang around when you have this. I'm in limbo. I can't get it on the NHS and I can't get it through my medical insurance. So I'm paying for the treatment myself.' A spokesman for Legal & General says: 'Where Herceptin is being used for the treatment of advanced stage breast cancer, we will pay for the treatment in the majority of cases.

'However, our healthcare policy is not designed to cover preventative treatment. Mrs Fahey does not have an acute condition which would be covered by her healthcare policy.' Two readers have told us that their insurer Axa PPP will only pay for them to receive Herceptin for nine months rather than the full course of 12 months, while they know of other women in similar circumstances who've been refused payment for the treatment altogether.

Jennie Tuck, 60, from Eccleshall in Staffordshire has had breast cancer twice in the past three years. Axa PPP took seven weeks to reply when she wrote to ask if the company would pay for her to have Herceptin. …

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