This drug together with another avastin has kept my husband alive despite being told by nhs oncologists that we should enjoy the summer implying it was his last (that was three years ago), and last year asked to take it "on the chin" that death was near. Not only is my husband alive but in good health. He has lung cancer and is a neversmoker. We have resources to pay for these drugs otherwise the nhs offers "best supportive care" ie death.
I sincerely hope nice members or those in the government who implement this do not get lung cancer. Or if they do are they going to die quietly.

J Ross, Harpenden, uk

my gran has lung cancer and she has a short while to live.
why does the govermant have to think about money before lives.if the goverment wants to think about money all the time then they should come face to face with the cancer victems.

wayne rowland, glossop, England

How dare polticians and their appointees play snakes and ladders with our health! There should be every effort made to increase the number of ladders, and every effort to eliminate the snakes. If value for money is their war cry, divert the massive funds still being wasted on the immoral and unwinnable Iraq war to our war on disease and illness at home - a truly noble and necessary cause.

Tim Newman, Callington, UK

In situations like this we should not blame NICE for not paying for the drug but we should blame the patent holder for charging so much for it. Tarceva is like anything else in a free enterprise economy, if it is fairly priced it will be bought, If the price is to high people will do with out it

Bob Yaes, Gaithersburg, USA/MD

Many drugs are approved for use in Scotland by NICE's equivalent body. If yehy are considered cost effective for the Scots, why are they not for the English? Is NICE itself cost effective? Why don't we abolish it, and ask the Sots to evaluate medicines fot the whole of the UK?

bob wilkinson, milnthorpe, Cumbria

The neo-liberal, neo-con agenda of the present capitalist era makes EVERYTHING an economic decision. How absurd of anyone to think that cancer patients wouldn't be subjected to the same trade-offs as any other segment of the political economy.

I'm fairly sure that a rich cancer sufferer will obtain all the Tarceva he or she could want. It's only money.

Tom Duncan, Astoria, OR/USA

If something is 'free' at the point of demand then there will be an imbalance between supply and demand and you must ration. This is a basic principle of economics taught to me when I was 14. Unfortunately this seems to be beyond most politicians.

The NHS will only be able to deliver drugs like this when people have to pay a significant portion of the cost and then they will make the decisions that NICE effectively does on their behalf and understand why they are being made, rather than just bleating they can't get something for free which has an significant cost.

Damian, London,

Why don't we scrap NICE and ask the Scots to advise on treatments and medication?

It would be quicker and cheaper (how cost effective is NICE?); and English and Welsh patients would not be disadvantaged, as they are at present.

bob wilkinson, milnthorpe, Cumbria

The comment from Anon is way off the mark. We know which patients are likely to benefit from Tarceva (either life long non smokers, females, adenocarcinoma pathology type and South East Asian origin)and the minimum NICE should have allowed is for them to have access to it. Responses are usually very quick so stopping the drug early in nonresponders cuts down expense. I have patients whose existance depends on Tarceva. Thank God I started them on this drug before this ridiculous decision. What is the point in doing any more cancer research when virtually every new treatment is denied to the patients by what is actually the Nasty Institute of Cost Effectiveness.

Dr Paul Burt, Manchester, UK

I agree that Tarceva, and other molecularly targeted drugs, offer 'a big advance in a neglected area of cancer,' and that it is extremely valuable to the subset of patients in which it works.

This subset of patients, however, is small, and possible to pre-select. The overall effect of treating the general lung cancer population is not enough to justify the array of other more effective treatments (in cancer or other disease patients) that could be prescribed for the same cost.

Considering the design of such drugs to target a specific molecular mechanism, approval should go hand in hand with research (for which the technology is available in pharma) towards testing for these mechanisms, and thus to identify the subset of patients who have a chance of benefiting.

I applaud this brave decision by NICE, and hope, along with the approval of Herceptin with it's associated diagnostic for responders, this decision sends the right message to health care professionals.

Anon, Manchester,

My father died last june; he had lung cancer which was diagnosed too late and had spread everywhere. The specialists couldn't understand how he had managed to feel reasonably well for so long before deciding to have a check-up. He died six weeks after the first visit. However, more attention to palliative treatment is required, since his deterioration was drastic and painful, and we were told there was absolutely nothing that could have been done to make it any easier. There's got to be something.

Martin Gaudiano, Caserta, Italy

A minimum cost of of £25 Billion projected to be the cost of the early stages of developing another Trident missile and we cant afford to treat lung cancer sufferers ? Government policies (withdrawing finance for caring for the elderly at home , etc) will reduce the quality of life for many people.
It is appalling that a Government can make a decision to refuse treatment to cancer patients.
Curious that it's lung cancer, of course it would be very cynical of me to suspect a link to smoking having anything to do with that decision, wouldn't it ? !!

A Wood, Mid Wales,

What did Blair say 'Heath,Heath ,Heath'
he didn't say whose.
He meant War, War, War.
It is incredible what a mess Blair has made of this once fine country in ten long years

Ian, Leicester, England

My God,we have billions for the War in Iraq,but we have nothing for cancer sufferers who have paid thousands in Tax over their working lives.
A disgrace.

Michael Rigby, Blackburn, England

Would an MP or any other government official be refused this treatment ? I doubt it. Yet another example of nasty NICE.

Steve P, Leeds, England