[Ip-health] Pharmafile: Sovaldi ‘unaffordable’ says NHS documents

Thiru Balasubramaniam thiru at keionline.org
Thu Oct 9 02:36:30 PDT 2014

Sovaldi ‘unaffordable’ says NHS documents
*Published on 07/10/14 at 09:42am*
Senior health officials may have to bar Gilead’s new hepatitis C pill
Sovaldi from being funded on the NHS after new data shows it would cost the
health service £1 billion a year to fund.

This comes despite NICE saying in recent draft guidance that it is willing
to pay for the treatment, which costs around £35,000 per patient, making it
one of the most expensive drugs outside of oncology in the world.

On top of this, an additional £2,400 for Roche’s ageing injectable
treatment Copegus (ribavirin) would also need to be added on as this is
required for the full course of treatment.

NHS England’s specialist commissioning fund is currently paying £18.7
million for the drug as it is being assessed by NICE, with around 500
patients already gaining access to the medicine.

But according to the internal NHS documents seen by the Health Service
Journal, NHS officials have written in a briefing note that the £1 billion
estimated cost of providing the drug to 20,000 hepatitis C patients was

Recent clinical trial data show Sovaldi
can effectively cure the disease in over 90% of patients in just 12 weeks.
This is compared to other treatments such as Vertex’ Incivek (telaprevir)
and Merck’s Victrelis (boceprevir), which take double the amount of time to
treat and have cure rates of around 75 per cent.

This could, theoretically, almost cure the disease in an entire patient

The efficacy of Sovaldi has also translated into astonishing sales –
hitting over $2 billion in its first quarter for 2014 and $3.2 billion in
its second – making it the fastest-selling medicine in the world and on
course to break the $10 billion barrier by next year, should this
trajectory hold.

NHS England, and now NICE, say that despite the price tag the drug is in
fact ‘highly cost-effective’ as it can potentially help stop the need for
liver transplants, which cost around £50,000 per patient.

But the NHS briefing document says these savings would not be seen for many
years or even decades, and the £1 billion cost for 2015 alone would mean
around 1% of the total NHS budget and 12% of the patented medicines budget
would be going on just one treatment.

Given the fact that the NHS is set to be in a £30 billion deficit by the
end of the decade and the government is already squeezing the drugs budget
and other services, it will come as no surprise that this figure is simply
unaffordable to the NHS.

There are other new hep C medicines on the horizon that combined with
Sovaldi could increase cure rates further however, with rival firms also
free to lower the price of their medicines to make them more appealing.

But Charles Gore, chief executive of the Hepatitis C Trust, questioned
whether the drug was being singled out because the disease predominately
affects disadvantaged groups.

“I doubt if this same affordability question would be there in the face of
a cost-effective treatment for cancer,” he says.

Another leading doctor told the Independent newspaper that the NHS’
proposed course of action set “a dangerous precedent that the NHS is only
going to treat people with severe diseases”.

*Ben Adams*

More information about the Ip-health mailing list