Cancer drug firms told to lower prices

The drugs companies behind two new cancer treatments deemed too expensive for use in Ireland have been told to lower their prices if they want their product prescribed.

Lung cancer drug crizotinib which retails under the name Xalkori, and breast cancer drug, pertuzumab, which sells as Perjeta, have both been found in trials to improve the quality of life for patients with specific advanced forms of the disease and, in the case of Perjeta, to boost survival rates.

But the National Centre for Pharmacoeconomics (NCPE), which is tasked with assessing whether new drugs represent value for money, has concluded neither is cost-effective and has recommended the HSE not fund them for public patients.

In the case of crizotinib, just 36 patients would be expected to need the drug over the next five years at a total cost of just over €5m.

The NCPE said: “At its current price, the NCPE cannot recommend crizotinib as a cost-effective treatment option. We do not consider the health benefit to be sufficient to justify the proposed price.”

Pertuzumab would be expected to be beneficial to around 130 women at a total cost of around €40m.

“A significant price reduction is required to ensure value for money,” it said.

The HSE will make the final decision and it takes into account factors other than cost, but with health budgets under intense scrutiny, it is pushing the manufacturers to review their prices. In a statement it said: “The HSE has engaged with each of the pharmaceutical companies to discuss the issues raised in the NCPE reports. It would not be appropriate for the HSE to make any additional comment on the specific agents at this time.”

It added it was also talking to Novartis about another drug, ruxolitinib or Jakavi, for the treatment of bone cancer and which the NCPE last month found not to be cost-effective.

Pfizer, which manufactures crizotinib, defended its position, saying the drug had already been approved for public patients in several European countries and the estimated cost of €5m over five years was not excessive.

“This is very low budget impact for an important innovation. Crizotinib represents a significant advance and we would urge that it is still considered for reimbursement,” said Pfizer Ireland’s Michael Riordan.

Roche said it respected the NCPE’s views and hinted there may be room for negotiation on price. “We look forward to working with the relevant agencies to bring Perjeta to women with metastatic breast cancer at a price that is acceptable to all parties.”

The Irish Cancer Society does not get involved in discussions about individual drugs, but it did call for greater debate on cancer drug prices in general. “If the outcome of the debate was a reduction in prices, the NCPE would be able to approve a greater volume of clinically significant treatments.”

The financing of drugs in public health systems will be discussed by international delegates at a two-day symposium to be opened by Minister of State at the Department of Health Alex White, in Dublin today.