Analysis: The drug buoyed by patient power

Most people heard about Herceptin last week. Roche's breast-cancer drug will be made available on the NHS to anyone who can benefit from it, Health Secretary Patricia Hewitt announced on 5 October.

The news followed the success of Barbara Clark, the 49-year-old nurse from Somerset who persuaded her local authority to cough up the £20,000 needed for her to receive the drug each year.

Herceptin is currently only licensed for the treatment of advanced breast cancer. But cancer charities and campaigners have been calling for an extended licence – to allow it to treat newly diagnosed women – to be granted as soon as possible. Some view Hewitt's move as a dangerous precedent, apparently pre-judging the licensing authorities and UK drug approval body NICE. The fresh news angles are thus many and varied.

The significance of the Herceptin case has not been lost on PROs, and it makes an engrossing case study of what Ozone MD Paul Jarman describes as a pharma campaign 'ticking all the boxes'. He says: 'Herceptin has a clear life-saving benefit in a treatment area with enormous sympathy, highly motivated patients and a horrendous inequity in funding.'

Tonic Life Communications CEO Scott Clark, who was involved in global pre-launch work for Herceptin at his previous agency, concurs: 'This is one of those legacy campaigns, perhaps in the top three in the past decade, that has had genuine impact. If people are sceptical of the power of PR, Roche has a clear case study on how a good story can move markets and mindsets.'

Media frenzy
Roche UK product comms head Susie Hackett says her team received around 50 calls a day at the height of the Herceptin frenzy.

'Journalists are calling us mainly for background on its licensing status and wanting to know when we're putting the licence application [for approval] in,' she explains.

Roche uses Ketchum to handle UK PR for the drug. Sébastien Desprez, associate director at the agency, can now reflect on an 'onslaught' of interest. He describes Barbara Clark, with whom Roche says it has only dealt reactively (supplying her with product information, and so on), as 'amazing at orchestrating PR'.

Separately, Fighting for Herceptin (FfH), established by a group of Staffordshire women, has also caught the media's attention. Porter Novelli has, it emerges, been advising FfH for the past month and has a four-strong team on the pro bono account. PN UK healthcare head Rebecca Hunt, who left a job at Roche earlier this year, says: 'I got to know FfH founder Dorothy Griffiths when I was at Roche, and we kept in touch. When Barbara Clark made the news I saw FfH was banging the drum too, and I asked Dorothy if she wanted any professional PR support.'

But Britain has many vocal patients and groups calling for greater funding for disease research and treatment. Why is Herceptin different? 'It was the women who brought this to life,' Hunt says.

'They are both articulate and self-starters. They have an extraordinary passion fuelled by a grotesque inequity.'

Of course, what Roche describes as 'stunning' clinical trial data has been crucial. These data were unveiled at a US oncology congress in May, when newspapers such as The Observer rallied round the drug.
Chris Mihill, co-founder of Clew Communications, is among many who are sceptical as to whether Roche PROs have been the primary instigators of the more recent coverage: 'Roche has largely been the happy inheritor of national news triggers: it's a fatal disease, we have a photogenic campaigning patient and an opportunity for people to attack the Government over health funding – all these news hooks were encapsulated in one story,' he says.

Axon Communications MD Ralph Sutton adds: 'Roche and Ketchum will have been building a groundswell of support. But a story like this will get a life of its own. The "breast cancer story" is always attention-grabbing news-wise – firstly, it affects a lot of people, and
secondly, it's curable in many cases.'

Safe distance
Roche is delighted at the positive PR being generated for its drug. But Mihill says: 'It is in Roche's best interests to maintain its distance from the patients – Herceptin is not licensed at the moment for early stage use and Roche would get into trouble with the ABPI for being seen to promote an unlicensed use of the medicine.'

Clark adds: 'Advocacy and empowerment campaigns must start and end with the patient. These campaigns can involve pharmas while not being exclusively driven by them. If they become self-serving, a backlash will certainly occur.'

Even as PRWeek went to press the story was taking fresh twists, with Roche facing criticism that it did not apply for regulatory approval earlier. And given the pressure on the drugs industry to ensure new drugs are properly tested for negative side effects (viz. the fallout from Merck's Vioxx withdrawal), there is a neat irony to the Herceptin affair. Clark says: 'A word of caution to others wanting to replicate the Herceptin campaign: gaining faster access to drugs is a double-edged sword because you need to balance efficacy with safety.'

Roche is now compiling a 3,000-page-plus Herceptin dossier that will be handed to the European drugs regulator. Ketchum, meanwhile, is planning for the Federation of European Cancer Societies' conference in Paris (30 October-3 November), when analysis of Herceptin data will be presented. 

Late last week, a separate cancer drug – Merck's Gardasil, for cervical cancer – had knocked Herceptin off the front pages.  But probably not for long. As Hunt asserts: 'People want access to Herceptin right now. They are like a dog with a bone.'