A £3,500-a-month drug proven to prolong the lives of kidney cancer patients is at the centre of a postcode lottery row, after five Midland primary care trusts have agreed to routinely fund it from tomorrow.
The Pan Birmingham Cancer Network will offer sunitinib (Sutent) to NHS patients being treated for advanced kidney cancer and gastrointestinal stromal tumours (GIST), a rare form of stomach and bowel cancer.
This means 104 kidney cancer patients and eight GIST patients will be able to get the drug, which randomised studies have shown adds on average 11 months to a patient's life, compared to five months on interferon-alpha, the standard treatment currently offered.
Patients receiving their first treatment for advanced kidney cancer and those who have stopped responding or cannot tolerate existing treatments will be eligible, as will those with advanced-stage GIST who are no longer responding to standard therapies.
The Pan-Birmingham network covers a population of 1.6 million, encompassing one strategic health authority, five PCTs and six hospital trusts. It is the third group of trusts in Britain to fund Sutent - it is already available from 12 PCTs in the North East and Yorkshire.
But patients living just a few miles outside the city, including Dudley, Warwickshire and Worcestershire, still have to plead their case to PCT bosses and in some cases resort to raising the money by selling their homes.
The National Institute for Clinical Excellence will assess the cost-effectiveness of four new cancer drugs - Sutent, Nexavar, Avastin and Torisel - in January 2009, but until then trusts will decide whether to fund it or not.
Each will be judged on price by looking at its QALY (quality adjusted life year) score, which rates the benefit it gives in quality and length of life compared to cost.
But Professor Emilio Porfiri, a cancer specialist at University Hospital Birmingham, thinks trusts will not consider routinely funding Sutent or any of the other new drugs until NICE announce their decision.
He said: "While this is great news for patients and doctors in Birmingham, there will still be problems with patients from Dudley, Warwickshire and Worcestershire, whose local trusts won't fund it.
"The expectation is other trusts will follow the Pan-Birmingham Cancer Network's decision, but until they do I and my colleagues will still be faced with patients for whom Sutent is not an option because the trust won't pay.
"It's extremely frustrating and upsetting to have to be the one to tell patients that, although there is a drug which is proven to prolong life, their PCT won't fund it.
"Until last year we had nothing to offer patients any real hope, we only had immunotherapy, but Sutent gives them real hope of survival - if you live in one of the few areas where it is funded."
More than 6,600 people are diagnosed with kidney cancer each year in the UK, of which around 3,000 will die, and there are about 900 GIST cases annually.