Charity calls for end to 'inflated' cancer drug prices

A UK cancer charity has criticised the 'inflated' cancer drug prices set by pharma, and also wants the government, regulators and industry to fix the current dysfunctional and inequitable drug appraisal system.

Breast Cancer Breakthrough launched its Demand A Fair Price campaign six weeks ago, calling on pharma companies, NICE and the government to work together to solve problems of access to new breast cancer treatments.

The charity raised its concerns at its annual reception in the House of Commons yesterday, and urged politicians from all parties to make it an election issue.

At the centre of the campaign are two drugs from Roche – Kadcyla and Perjeta – which are currently not approved by England's cost-effectiveness watchdog NICE, and Scotland's equivalent the SMC.

England currently has a separate Cancer Drugs Fund, which means patients in England can gain access to such drugs, even when NICE has rejected them – but this system is now under review.

The charity says pharma companies must do more to reduce the high costs of their drugs, but is also calling for reform of the appraisal system as well.

The campaign is significant in that patient groups have rarely criticised UK pharma drug pricing, until now. The charity made its position clear, saying: "Inflated prices being set for these treatments" are creating a barrier which no regulatory system can overcome."

It laid out three clear calls to action as part of the Demand a Fair Price campaign. In the short term it wants to see:

* Commitment from all political parties to extend the Cancer Drugs Fund in England until 2020, the end of the next parliament

 * All political parties to commit within their manifestos to finding a long-term, UK wide solution to the problem of lack of routine access to life-extending drugs by the end of the next parliament, working with the pharmaceutical industry and patient groups

 * The Welsh and Northern Ireland assemblies to introduce a similar system to the Cancer Drugs Fund to ensure that patients get access to the drugs they need

The charity says it is the inequality of access which is its number one target: it wants to ensure that all women have access to the drugs they need – irrespective of where in the UK they live.

It says it is committed to working closely with government, industry and stakeholders to develop and embed a new system of drug pricing and evaluation.

As part of the campaign, Breakthrough is asking the public to encourage their local MP to raise the issue in parliament and make sure their party leader makes a commitment in their election manifesto to tackle the issue.

No more 'sticking plasters'

Chris Askew, chief executive of Breakthrough Breast Cancer, said: "We are determined to stop breast cancer for good, and making sure every woman receives the treatment she needs is the first step. In the last year alone, three promising drugs for secondary breast cancer have been rejected for routine use on the NHS due to their high cost.

"The Cancer Drugs Fund was only supposed to be a temporary solution and, while it should remain until a workable alternative is found, it is merely papering over the cracks of a system which is no longer fit for purpose.

"The Government has already made attempts to reform the system in England – a positive step forward – but this is a problem that will need long-term solution, not a series of sticking plasters. With no CDF in place, patients in Wales, Scotland and Northern Ireland are being denied the drugs they need. If we are serious about beating cancer, this unacceptable situation must be addressed.

"Innovative, effective drugs sitting on the shelf are of no use to anybody, least of all patients. Whilst there will be no quick fix solution to this problem, the pharmaceutical industry will need to get serious about its pricing and whoever forms the next government will need to get a grip on the problem and take action to resolve it.

"Until we have a sustainable, UK-wide system in place, the future availability of the treatments that regulators are being continually forced to reject will remain uncertain."

Dr Nicholas Turner is an academic consultant medical oncologist who specialises in the treatment of breast cancer and team leader at the Breakthrough Toby Robins Breast Cancer Research Centre at the Institute of Cancer Research, London. He said: "Thanks to research breakthroughs, we've made huge advances in how we treat breast cancer and targeted drugs for secondary breast cancer are more effective than ever before. But the fact is that these new and highly effective drugs are not getting to those that need them and it's frustrating to see for all involved.

He added: "We must find a way to make the drugs that offer the best hope for women and their families available to them on a consistent basis."

Heather Lawrence, who has been living with secondary breast cancer since 2008, said: "The myth that women like me are all spending our days suffering and immobile getting more and more ill still endures despite the fact that it is no longer the case for many people.

"The formidable cost of new tailored treatments is a hurdle, but don't forget that we are mothers, sisters, daughters; we run our households, we work and pay our bills, we are responsible for raising the next generation, we matter to a whole network of lives around us. When we die, the shockwaves radiate outwards, and every life in that network is touched for the worse leaving a tear in the fabric of our families and our communities."

Sharon Hodgson MP, co-chair of the All Party Parliamentary Group on Breast Cancer, who spoke at the parliamentary reception said: "Ahead of the general election, I will be supporting Breakthrough in calling on all political parties, including my own, to commit to solving the issues that currently exist around access to drugs. This will come from negotiations and ongoing discussion with pharmaceutical companies, regulators and charities to create a new system which will ensure all cancer patients across the UK can access the drugs they need at a fair price to the NHS.

"We've come a long way in developing new and better drugs for breast cancer but to keep moving towards a future where women can live longer feeling well, spend less time in hospital with debilitating side effects and more time with their families, and keep working if they are able to, we need to find a way to guarantee access to the drugs that can make this possible."

ABPI response

UK pharma industry association the ABPI has responded to the charity campaign, agreeing that the CDF was a 'sticking plaster' solution, and required a new, long-term reappraisal.

It says it opposes the CDF being continued until 2020. One of the issues within the UK pharma sector is the sentiment that cancer receives 'special treatment' which diverts funding from other disease areas, creating objections among companies not operating in the cancer field.

The ABPI says it advocated a reform of the NICE system, which would mean the CDF would no longer be necessary. It says it fear a continuing CDF will create a alternative and potentially duplicative NHS England-led value assessment process which will not be an efficient use of NHS resources.