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Summary of Results

Health Topic:   Cancer
Guidance:   Breast cancer - trastuzumab
Description:   The summary of the published technology appraisal on Breast cancer - trastuzumab. It links to the published guidance and key documents.

NICE implementation uptake reports

Implementation uptake report Assessment Published Date Coverage

External literature

External literature Assessment Coverage

Richards M (2004) "Variations in usage of cancer drugs approved by NICE: Report of the Review undertaken by the National Cancer Director." Department of Health: London.

Description: This review conducted by the National Cancer Director in 2004 reported that (i) overall usage of cancer drugs had generally increased following a positive NICE appraisal, (ii) there was considerable variation in usage among cancer networks that could not be accounted for by differences in case-mix alone. A further review was conducted in 2005 and published in September 2006 showing significant reductions in the levels of variation across cancer networks.

Doubts about or mixed impact in practice National

Breakthrough Breast Cancer, Breast Cancer Care, CancerBACUP et al. (2003) The implementation of NICE guidance

Description: A survey of 304 PCTs in England. The results show that the guidance on trastuzumab is being implemented. There are however, variations in how this is being monitored.

Practice appears to be in line with guidance National

Richard M (2006) Usage of cancer drugs approved by NICE: Report of Review undertaken by the National Cancer Director London: Department of Health

Description: The 2006 report shows: (i) a continued increase in uptake of cancer drugs following a positive NICE appraisal, (ii) a reduction in the variation in usage of all 15 NICE-approved drugs since a 2003 analysis. Variations in usage between cancer networks were wider for some NICE-approved drugs than others. The X-fold variation in usage for Trastuzumab (Herceptin) over the first half of 2005 was 2.8, a reduction in variation of 33% since the second half of 2003.

Doubts about or mixed impact in practice National

The Healthcare Commission (2007) The best medicine: the management of medicines in acute and specialist trusts London: Healthcare Commission

Description: A national review of medicines management in 173 acute and specialist NHS trusts in England. Data from a trust questionnaire as part of this review found that 95% of organisations treat some patients according to guidance and 81% treat all patients according to the guidance. 89% of trusts have an agreement about funding in place with commissioners and 53% of organisations reported having an audit completed or in progress.

Doubts about or mixed impact in practice National

Department of Health (2009) Uptake of NICE approved cancer drugs 2007/2008 London: Department of Health

Description: An analysis of prescribing data across cancer networks. Data show a 291% increase in prescribing of trastuzumab from 2005 to 2007/08 and a 44% reduction in variation across networks (NB data is not linked to diagnosis).

Practice appears to be in line with guidance National

Breakthrough Breast Cancer, Breast Cancer Care, CancerBACUP et al. (2003) The implementation of NICE guidance

Description: A survey of 304 PCTs in England. The results show that the guidance on trastuzumab is being implemented. There are however, variations in how this is being monitored.

Practice appears to be in line with guidance National

NHS Information Centre for Health and Social Care (2009) Use of NICE appraised medicines in the NHS in England-Experimental Statistics

Description: Estimated numbers of eligible patients were derived from NICE costing templates. Data for trastuzumab was obtained from the Hospital Pharmacy Audit Index. The NICE costing template expected an annual number of 5,218 patients. However the authors found no way to convert this figure to a predicted number of doses.

Not graded National

The NHS Information Centre for Health and Social Care (2011) Use of NICE-appraised medicines in the NHS in England-2009, Experimental Statistics

Description: This is the second report commissioned by the Metrics Working Group to look at the variation in use of postively appraised medicines in relation to the expected use as predicted by NICE. In all, 47 medicines in 18 groups, relating to 29 technology appraisals were considered. Out of the 12 groups where a comparison could be made (these are presented in Section 1 of the technology section results), observed use by the NHS in England was higher than the predicted use for eight and lower for three.

Not graded National

Richards, M (2010) Extent and causes of international variation in drug usage: A report for the Secretary of State for Health by Professor Sir Mike Richards CBE

Description: This report looks at medicines usage between countries, using IMS Health data. The WHO defined daily dose or the maximum or prescribed daily dose was used to measure usage. Results rank the UK relative to other countries usage and present calculations showing how close or otherwise the UK is to the average use across groups of other countries. It should be noted that countries other than the UK would not be expected to adhere to NICE guidance making comparisons between countries not possible.

Not graded National

Health and Social Care Information Centre (2012) Use of NICE-appraised medicines in the NHS in England - 2010 and 2011, Experimental Statistics

Description: This is the 3rd report published by the HSCIC on behalf of the DH to look at the variation in use of positively appraised medicines in relation to the expected use as predicted by NICE. In all, 52 medicines in 25 groups, relating to 35 technology appraisals were considered. Out of the 12 groups where a comparison could be made, observed use by the NHS in England was higher than the predicted use for 6 and lower for 6. For one drug group use was lower on one measure, and higher on another.

Not graded National

This page was last updated: 01 October 2012

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Accessibility | Cymraeg | Freedom of information | Vision Impaired | Contact Us | Glossary | Data protection | Copyright | Disclaimer | Terms and conditions

Copyright 2014 National Institute for Health and Care Excellence. All rights reserved.

Accessibility | Cymraeg | Freedom of information | Vision Impaired | Contact Us | Glossary | Data protection | Copyright | Disclaimer | Terms and conditions

Copyright 2014 National Institute for Health and Care Excellence. All rights reserved.