The new cash injection into the Cancer Drugs Fund is just political “smoke and mirrors”, and there will be no incentive for pharma to reduce its drug prices, a leading cancer expert has said.
In response to the news that the Fund would receive an extra £160 million over the next two years, Karol Sikora, chief medical officer at Cancer Partners UK, told PharmaTimes Magazine this was a “political fudge, an act of smoke and mirrors to allow politicians to say everybody can get any cancer drug whereas the reality is very different”. He says the amount being pumped into the Fund – which pays for cancer drugs not deemed cost-effective by NICE – is peanuts when the cost of new drugs is often more than £50,000 a year per patient.
The government also announced that in future only drugs considered value-for-money will be allowed under the Fund. This bid to incentivise pharma to cut its prices means the least clinically effective drugs are likely to be dropped, although current patients won’t have their treatments terminated. It is also hoped this will make better use of the money available under the Fund, which is set to run until March 2016 and has helped more than 55,000 cancer patients since it was set up four years ago.
However, Prof Sikora remains sceptical that these changes will make any difference to drug prices. “Big pharma has got greedy. We saw a price explosion 20 years ago with platinum and taxol, then again with Herceptin, but now the market just won’t bear the prices except in the USA – and even there it’s still too high,” he says. “Pharma doesn’t care about the real value these drugs have.”
In the past month, NICE has rejected two cancer drugs – Roche’s Kadcyla (trastuzumab emtansine) for breast cancer and Johnson & Johnson’s Zytiga (abiraterone) for prostate cancer – for use on the NHS because of the high price tags. They will now be available on the CDF but the decisions have generated much media talk and pharma stands accused of choosing prices that block access to drugs.
NHS England, which will now negotiate with pharma over its prices, will work with the CDF, NICE, patient groups and the ABPI to look at ways to create better alignment between the CDF and the NICE assessment process.
Prof Sikora suggests “deleting” all drugs where the pivotal study shows less than six months survival improvement when randomised to best available care. Meanwhile, pharmacologist David Colquhoun told BBC’s Newsnight programme that “axing the Fund is the only way to go – you have to stand up to these companies and I believe they will probably back down in the end, but it won’t be easy.”
While many charities have welcomed the funding boost for the CDF, they warn it’s not a long-term solution. Says Mark Flannagan, chief executive of Beating Bowel Cancer: “It’s vital we have a sustainable solution for access to new cancer drugs. If common sense is to prevail then all sides must play their part so new effective treatments reach the people who need them most. NICE and the pharmaceutical industry must show greater flexibility and a genuine willingness to work together in the interests of all cancer patients.”
This story was published in the September issue of PharmaTimes Magazine. You can access the digital issue to read this and more stories here.