Health authorities will have to find millions of pounds to fund cancer drugs after the National Institute for Clinical Excellence backed the use of paclitaxel to treat patients with ovarian cancer.
HAs will have to pay for supplies of the drug (better known under the brand name Taxol) for newly diagnosed patients and women who are already being treated at a cost of roughly£10,000 per treatment.
The cost could spiral because manufacturer Bristol Myers Squibb has appealed against NICE's decision to limit the use of the drug for breast cancer, which affects twice as many women.
The draft guidance on breast cancer has been sent back to NICE's advisers and the final version will not be launched until June.
Jean Mossman, chief executive of CancerBACUP, welcomed the judgement on ovarian cancer but said both paclitaxel and docetaxel (brand name Taxotere) should be licensed for breast cancer patients once first-line therapy had been tried.
'It is important that patients should have access to the best treatment for each individual. My concern is the way HAs respond to the NICE appraisal. If HAs don't have to pay for both they won't.'
Up to 30 HAs have refused to fund paclitaxel before definitive national guidance on its effectiveness, leading to accusations of 'postcode prescribing'.
Wiltshire even turned down resident Monica Willis's offer to pay£10,000 for her own treatment in the NHS in 1997. The HA is now urgently reviewing its policy.
Chief executive Jeremy Hallet said it had budgeted£1m to meet every NICE recommendation this year. With 55 ovarian cancer cases in Wiltshire every year, last week's judgement alone could cost almost half this budget.
The Department of Health told hospitals to send copies of the NICE judgement to every oncologist and cancer specialist and work with HAs, primary care groups and trusts to make sure money is available.