Healthy Skepticism Library item: 14923

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Publication type: news

Campbell D.
NHS patients to get better drug access
Guardian.co.uk 2009 Jan 11
http://www.guardian.co.uk/society/2009/jan/11/health-nhs-pharmaceuticals-drugs

Abstract:

Secret talks with makers widens treatment for people with serious illnesses

Full text:

Tens of thousands of patients are set to receive expensive drugs currently banned on the NHS, following secret talks between the government and manufacturers.

Pharmaceutical companies are poised to agree a groundbreaking series of deals to reduce the price of certain treatments in order to make them available across the country. People who have cancer, arthritis and Crohn’s disease are likely to be among the first beneficiaries of a new agreement, which aims to end the controversy over sufferers being denied access to life-saving drugs.

The Department of Health and the drug industry have been holding negotiations for several months about the widespread adoption of creative pricing deals to overcome the National Institute for Health and Clinical Excellence’s (Nice) refusal to approve new, clinically effective treatments it deems too costly.

The result will be pricing schemes that will make the drugs cheaper, and therefore affordable to the NHS. These include cost-sharing, where firms offer refunds for patients whose condition has not improved after using their product, and schemes in which they give small groups of sufferers a drug at a discounted rate in order to prove its effectiveness.

Doctors, charities and patient groups have condemned Nice for rejecting a series of drugs which experts believe relieve suffering or prolong life. While campaigns have forced some primary care trusts to rethink decisions to refuse certain costly medicines, this new approach will transform access.

Thousands of people with multiple myeloma, the incurable blood cancer, may now start getting Revlimid. Health officials and its makers, Celgene, have been discussing a cost-sharing deal under which the NHS would buy the drug at its full price but, in return, the company would refund payments where there was no improvement. Last October, Nice ruled that, although clinically effective, Revlimid was not cost effective and withheld approval.

Nice has recently shown its willingness to soften its stance if a drug firm embraces creative pricing. For example, it approved Lucentis, which helps people with age-related wet macular degeneration avoid going blind, after the drug firm Novartis agreed to cover the cost of any patient who, after receiving 14 separate injections, still needed more.

Each injection costs £761. Then, in a deal brokered by Department of Health officials, Nice approved the lung cancer drug Tarceva after its producer, Roche, agreed to drop the price to match that of the existing standard chemotherapy treatment.

Other drugs involved in the talks include Infliximab, which is used to treat the debilitating bowel complaint Crohn’s disease; Velcade, for multiple myeloma; and both Orencia and Humira, which can reduce the pain of arthritis.

Rachel Rowson, of Macmillan Cancer Support, said: “We welcome the move towards cost sharing on expensive drugs as it will allow more patients access to those desperately needed drugs.”

Nice will this week perform a major U-turn in an attempt to end the row over its refusal to approve four kidney cancer drugs. Well-placed sources say some drugs will be made available when its committee meets on Wednesday as a result of discussions about pricing, new clinical trial data and health secretary Alan Johnson’s demand for a much less rigid approach to letting patients with terminal conditions have access to end of life treatments.

The talks follow an agreement the Department of Health struck with the industry last November, which formalised and encouraged creative pricing. Health minister Ben Bradshaw told the Observer: “Patients rightly want and deserve access to effective and innovative treatments … more patients will [now] benefit from a wider range of clinically and cost-effective drugs.”