[Ip-health] Breast cancer drug Kadcyla to remain on NHS after manufacturer lowers price

Claire Cassedy claire.cassedy at keionline.org
Wed Nov 4 09:07:54 PST 2015


Breast cancer drug Kadcyla to remain on NHS after manufacturer lowers price

Drug was set to be dumped from UK’s list of approved medicines before deal
was reached with pharmaceutical firm Roche

Sarah Boseley - Health editor

Wednesday 4 November 2015 10.54 EST

An expensive drug that could prolong the lives of women with advanced
breast cancer by at least six months will remain on the list of medicines
available on the NHS after the manufacturer agreed to lower the price.

Roche’s Kadcyla was one of a number of drugs set to be dumped from the
Cancer Drugs Fund (CDF) list of medicines that the government pays for
because the National Institute for Health and Care Excellence (Nice) does
not consider them to be cost-effective.
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In the case of Kadcyla, cost was the only issue. Nice and NHS England
accept that the drug works well and can extend women’s lives significantly
without severe side-effects. But Roche launched the drug at £90,000 per
patient per year, which is nearly double the limit for Nice approval.

Roche would not divulge the details of the deal, which it said were
commercially confidential. The original price, however, was £5,900 a month
and patients tended to be on it for an average of 9.6 months, it said,
bringing the real cost to the NHS down to about £60,000. The discount is
likely to bring the cost close to the Nice threshold of £50,000 a year for
an end-of-life drug.

According to Roche, 1,300 women could benefit from Kadcyla, which is for
those with a form of breast cancer called Her2 positive, once the drug
Herceptin ceases to work.

Other Roche drugs are still off the list, however. Avastin for cervical
cancer stays, but may not be used in colorectal (bowel) cancer or in triple
negative breast cancer, because the evidence for its efficacy is still not
considered convincing.

Altogether, seven drug uses that were under threat will go back on the CDF
list, but 18 are confirmed as not available on the NHS. Prof Peter Clark,
the chair of the Cancer Drugs Fund and an oncologist, said: “We need to
ensure we get the maximum benefit for patients from the fixed pot of money
available, which is why we robustly assess the evidence on the
effectiveness of these drugs alongside their cost.

“In some cases the drugs we proposed to remove were the least effective on
the CDF list and we could not continue to fund them. In others they were
simply too expensive, so we are pleased the pharmaceutical companies worked
with us, reducing their prices, ensuring these treatments remain available
to patients.”

Patients who are on any of the drugs that are dropped will continue to get
them as long as they need them.

Breast Cancer Now, which organised a petition to Roche to drop the price of
Kadcyla that was signed by more than 42,000 people, was delighted by the

“We’re pleased that our voices have been heard,” said Delyth Morgan, its
chief executive. “It’s encouraging to learn that Roche and NHS England have
been able to come to a deal, but patients relying on other delisted drugs
such as the breast cancer drug Avastin for future treatments will no doubt
be devastated. There’s a bigger problem with our drug access and pricing
system that will not go away.

“Now we’re looking to the prime minister to show leadership on this issue.
A better, more flexible system will benefit the pharmaceutical industry,
healthcare professionals, and – most importantly of all – the patients
whose lives depend on these treatments.”

Prof Paul Workman, chief executive of the Institute of Cancer Research,
London, said: “It’s great news that some drugs that we thought could be
lost from the Cancer Drugs Fund are going to remain available for patients
– and at a more affordable cost to the NHS. However, we now have a
situation where some cancer drugs have been off, on, off and now back on
the list of available drugs. It’s extremely confusing, and for people with
cancer it’s also distressing, with such uncertainty about which drugs are
going to be available for them.

“Most of all, today’s announcement highlights the need for a unified,
long-term and sustainable system of drug evaluation … we need clarity where
there is currently confusion.”

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