Cancer drugs costs - HSE will not fund drug treatment

Every time a new wonder drug for treating cancer comes on the market, the hopes of patients seeking a miracle cure are inevitably raised, only to be dashed amid controversy over the exorbitant cost of treatment.

Ireland is no stranger to the long-running debate over the price of medicine. It is an argument that rages from the rooms of high earning consultant to the local pharmacy where over-the-counter products rank among the costliest in Europe. This ongoing dispute is rekindled by the latest advice to the HSE not to fund two new cancer drugs because they are too costly.

At the centre of debate are a breast cancer drug called Perjeta, produced by Roche, and a Pfizer drug for lung cancer called Xalkori. Both are too expensive for the HSE to fund, according to the National Centre for Pharmacoeconomics. Set up in 1998, it assesses all new medicines and advises the HSE on cost-effectiveness, value for money and the impact of reimbursing huge charges on the health service budget. In the case of oncology drugs, a report is also sent to the National Cancer Control Programme.

Though it concludes that Perjeta would significantly increase the average survival for patients, the report adds that a true estimate of the gain is still uncertain. Putting the price at €74,000 per patient for an average 18-month treatment, it estimates the cost to the HSE at €39m. That’s the cost of treating 130 patients here over the next five years who might benefit from the drug.

Similarly, in the case of Xalkori for adults with a previously treated form of lung cancer, the cost would run to nearly €50,000 for each of the 16 patients who might benefit this year, amounting to €6.2m over five years. Unsurprisingly, though it improves quality of life, the drug is not recommended as being cost-effective.

Obviously, while pharmaceutical companies are under pressure from shareholders to recover the cost of laboratory research, judging by the vast prices being charged in Ireland there ought to be lots of room for giving far better value for money than is now on offer. Otherwise, with the health service strapped for cash and the Government under increasing troika pressure to axe health expenditure, the prospects of patients being treated with high-cost drugs such as Perjeta or Xalkori look bleak indeed. Whether an exception will be made for the relatively small number of lung cancer patients remains to be seen.

Basically, there are two sides to this dilemma. Simply put, the HSE cannot afford to pour money it hasn’t got into treatments that have yet to be fully proven by global pharmaceutical companies. Like it or not, the industry stands accused of cynically exploiting the healthcare system, effectively putting its own financial health before the health of patients.

Meanwhile, on a far brighter note, The Irish Cancer Society has brought together Ireland’s leading breast cancer researchers in a five-year collaboration project that aims for better treatment for breast cancer.

In contrast with the disappointment inflicted on individual patients by the non-approval of costly treatment, the decision by most of Ireland’s leading breast cancer researchers to collaborate closely is said to be the first venture of its kind in the world. It will bring greater hope and certainty to women undergoing treatment for breast cancer. This is a most welcome development.