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Doctors say industry 'profiteering' threatens lives.
An influential group of cancer experts
has warned that the high prices charged by pharmaceutical companies for
cancer drugs are effectively condemning patients to death.
The group of more than 100 leading cancer
physicians from around the world, including nine from the UK, accuse
the drug industry of “profiteering” – making a profit by unethical
methods such as by raising the cost of grain after a natural disaster.
Of the 12 drugs approved by the Food and
Drug Administration in the US in 2012, 11 were priced above $100,000
(£65,000) per patient per year. In addition the price of existing drugs
of proven effectiveness has been increased by up to threefold.
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The specialists say: “What determines a
morally justifiable ‘just price’ for a cancer drug? A reasonable drug
price should maintain healthy pharmaceutical industry profits without
being viewed as ‘profiteering’. This term [profiteering] may apply to
the trend of high drug prices where a life threatening medical condition
is the disaster.”
The high prices mean the drugs may not be
approved by the National Institute for Clinical Excellence in the UK
forcing doctors to fill in a 14 page application apply to the Cancer
Drugs fund for British patients who could benefit from them.
In addition, the rising cost of existing
drugs in a cash limited health service such as the NHS means treatment
is denied to other patients with other conditions.
The authors of the article, published in the journalBlood, are all specialists in blood cancers such as leukaemia, where cancer drugs have proved most effective.
One of the best known – imatinib, whose
brand name is Glivec – has proved so successful in chronic myeloid
leukaemia that patients who a decade ago survived for a few years can
now look forward to a near-normal life expectancy.
But the cost of Glivec has risen from
£18,000 per patient per year to around £21,000 in the UK, and from
$30,000 to $92,000 in the US. This is despite the fact that all research
costs were covered by the original price, and the number of patients
treated and the length of time they are on the drug have both vastly
increased because of the drug’s success.
Daniel Vasella, former chairman and chief
executive of Novartis, the manufacturer, said the original price
charged for Glivec in 2001 was considered “high but worthwhile” and was
estimated to yield annual revenues of $900 million, enough to cover its
development cost in two years. A decade later Its annual revenues in
2012 were $4.7 billion (£3 billion).
The cancer specialists say the revenue
earned by Glivec over the last ten years “represent generous profits to
the company”. But this has put heavy pressure on those who have to foot
the bill. “Grateful patients may have become the financial victims of
the treatment success, having to pay the high price annually to stay
alive”.
In the US even those with health
insurance may pay an average of 20 per cent of drug prices out of
pocket. Drug prices are the single most frequent cause of personal
bankruptcies in the US.
Three new drugs have been approved for
chronic myeloid leukaemia in the last year by the FDA but the prices are
“astronomical” the authors say at up to $138,000 a year per patient.
Worldwide only about a quarter of the
patients with chronic myeloid leukaemia who could benefit have access to
drugs because of the cost. “A small fraction are rich enough to pay
individually, and most are treated intermittently or not at all. The
effects of these financial pressures on long term survival… are yet
unknown.”
In the UK, patients are shielded from the
“direct economic anxieties of illness”, the article says. But
Professor Jane Apperley, chair of the Department of Haematology at
Imperial College, London, and one of the authors, said high drug prices
were still a cause of harm in Britain .
“The price of a drug heavily influences
the decision of NICE whether we can prescribe it on the NHS. I am chief
of service at Imperial College and we are constantly being asked to
reduce our spending. We have to look very carefully at the cost of the
drugs we use.”
“Of course we need the pharmaceutical
industry to go on developing new drugs. It is very exciting that a
number of cancers are now becoming susceptible to these new drugs. But
the rising cost is unsustainable. “
“The drugs are very effective at keeping
people alive. But if they are priced out of what you can afford you know
that you can keep people alive but you can’t afford to do so. It is
completely unsustainable for the NHS because the costs are going up
every year. We need a serious dialogue about whether we can sustain
these costs.”
The authors of the article in Blood
conclude: “We believe the unsustainable drug prices may be causing harm
to patients. Advocating for lower drug prices is a necessity to save the
lives of patients who cannot afford them. We believe drug prices should
reflect objective measures of benefit, but should not exceed values
that harm our patients and societies.”
The group say they intend to organise regular meetings and campaign for lower cancer drug prices.
A spokesperson for the UK charity Beating
Blood Cancers said: “As a charity we want to see an ethical approach to
drug pricing . There is no point in us investing in research if the
pricing policy means drugs won’t be available to patients.”
In a statement to The Independent,
Novartis said: “We recognize that sustainability of health care systems
is a complex topic and we welcome the opportunity to be part of the
dialogue. Our critical role, as one of many parties working towards
improving cancer care, is to discover and develop innovative
treatments.”
“ Novartis innovation in chronic myeloid leukemia (CML) has changed the course of the disease. Before Glivec(imatinib)* and
Tasigna (nilotinib), the five-year survival in CML was only 30 percent.
Today, nine out of ten patients with CML have a normal lifespan and are
leading productive lives.”
“Over the years, our programs have
evolved to improve patient access to our medicines. We work together
with government health care systems, charities and other payers to build
successful cost-sharing models.”
Expert view: ‘Price of drugs is harming patients’
The following is an extract from an
article, contributed to by more than 100 leading cancer physicians from
around the world, including nine from the UK, published in the journal,
Blood.
This perspective reflects the views of a
large group of CML experts, who believe the current [high] prices of
drugs may compromise access of needy patients to highly effective
therapy, and are harmful to the sustainability of our national
healthcare systems...
If drug price reflects value, then it
should be proportional to the benefit to patients in objective measures,
such as survival prolongation, degree of tumour shrinkage, or improved
quality of life. For many tumours, drug prices do not reflect these
endpoints, since most anti-cancer drugs provide minor survival benefits,
if at all.
As physicians, we… believe the
unsustainable drug prices in CML and cancer may be causing harm to
patients. Advocating for lower drug prices is a necessity to save the
lives of patients who cannot afford them … For CML, and for other
cancers, we believe drug prices should reflect objective measures of
benefit, but should also not exceed values that harm our patients and
societies.”
An ethical price tag? Cancer drugs
Brands used for the treatment of chronic myeloid leukaemia
Imatinib (Glivec) £21,000 per patient per year - Novartis
Designed from first principles, it proved hugely effective and unexpectedly turned into a blockbuster, earning billions of pounds for its makers.
Designed from first principles, it proved hugely effective and unexpectedly turned into a blockbuster, earning billions of pounds for its makers.
Nilotinib (Tasigna) £21,000 - Novartis
Designed for patients who fail to respond to Glivec, Novartis reduced the cost to get it past Nice, whilst increasing the cost of Glivec.
Designed for patients who fail to respond to Glivec, Novartis reduced the cost to get it past Nice, whilst increasing the cost of Glivec.
Dasatinib (Sprycel) £31,000 - Bristol Myers Squibb
Also designed for patients who cannot take Glivec. But it has not been approved by Nice for use on the NHS because of its high cost.
Also designed for patients who cannot take Glivec. But it has not been approved by Nice for use on the NHS because of its high cost.
Bosutinib (Bosulif) £76,000 - Pfizer
For patients who suffer side-effects from the other drugs. It won approval in the US in 2012 but is awaiting a licence in the UK.
For patients who suffer side-effects from the other drugs. It won approval in the US in 2012 but is awaiting a licence in the UK.
Omacetaxine (Synribo) £100,000 - Teva
For patients who cannot tolerate other drugs. Approved in US in 2012 but awaiting licence in the UK.
For patients who cannot tolerate other drugs. Approved in US in 2012 but awaiting licence in the UK.
Ponatinib (Iclusig) £90,000 - Ariad
A third-generation drug which works in a different way. Approved in the US in 2012 but awaiting a licence in the UK.
A third-generation drug which works in a different way. Approved in the US in 2012 but awaiting a licence in the UK.
Source:
www.independent.co.uk
http://worldtruth.tv
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