Priority for caregivers, not shareholders: Why campaigners support a ban on Roche's new cancer treatment

Nice had 'no option' but to reject Kadcyla at its current price

Share

Most of us know someone with breast cancer. Some of us have friends or relatives who have died of it. So any controversy about a new drug therapy is bound to raise strong feelings, especially if the headline news is about women in the late stages of the disease being denied treatment on grounds of cost. It happened again last week, when the National Institute for Health and Care Excellence (Nice) announced that a "revolutionary" new drug called Kadcyla was too expensive to be made available on the NHS. Nice said that the cost of the drug – £90,000 per patient – was prohibitive.

For the patients who would benefit from Kadcyla, this is disastrous news. It has been shown to extend life expectancy by six months in women in the late stages of the HER2-positive form of the disease. Some of them will almost certainly die while the row between Nice and the drug's manufacturer, the Swiss-based pharmaceutical giant Roche, rumbles on. It doesn't help that Nice has previously made questionable decisions, such as initially limiting access to another breast cancer drug, Herceptin, to women with advanced cancer.

Herceptin (also made by Roche) is much cheaper than Kadcyla, costing the NHS around £22,000 per patient per year. After a flood of appeals and the threat of court action, Nice did the right thing, changing its guidance and making Herceptin available to women who have just been diagnosed. Kadcyla contains the same ingredients as Herceptin but it also contains a chemotherapy element which acts directly on cancer cells, avoiding damage to healthy cells and causing fewer side-effects.

Even so, there is a great deal more to this story than the cash-strapped NHS making a mean decision and condemning desperate patients to a premature death. Roche would certainly like the public to believe that; it went on the offensive last week, making its arguments on news programmes and to health correspondents. It pointed out that Kadcyla has taken 30 years to develop and said that other European countries, including Switzerland and Austria, have not baulked at the enormous price tag.

What it didn't talk about was the economics behind the company's pricing decisions, which can be summarised quite starkly. Four of its five top-selling drugs are for cancer and they are showing healthy growth: sales of Herceptin are up by 6 per cent while Avastin, a treatment for several different cancers, is showing growth of 13 per cent. Hence a slew of headlines along these lines in the trade press: "Roche cancer drugs drive healthy sales rise" and "Sales of cancer drugs soar once again at Roche".

The crucial thing about Kadcyla is that it is likely to be of use to far fewer patients than Herceptin. Every year, almost 50,000 patients are diagnosed with breast cancer in the UK and around 11,500 die of it. But Kadcyla would benefit only 1,500 British women per year, according to some estimates. This is not to question whether women with aggressive forms of breast cancer should in principle have access to the most modern and effective drugs. It is to raise questions about the corporate social responsibility of big pharmaceutical companies, which have a duty to patients as well as shareholders. Roche's own code of conduct includes a commitment to maintaining "high ethical and social standards in our business dealings". But the company's "commitment to society" comes after this unequivocal statement: "We aim to continuously create value for our stakeholders and to achieve sustainable, high profitability".

Nice has been negotiating with Roche over Kadcyla since April and the company says it offered a lower, but so far undisclosed, price in recent weeks. In the past, doctors and charities have criticised Nice for decisions which deny life-extending drugs to sick people, but this time the response has been markedly different. Sally Greenbrook of Breakthrough Breast Cancer described Kadcyla as a brilliant drug but said it was "incredibly expensive". She credited Nice with going "over and above their usual processes" to try to approve it and called for the price of life-extending drugs to come down. Mia Rosenblatt, head of policy and campaigns at the Breast Cancer Campaign, said she was "hugely disappointed" by the decision but recognised that Nice had "no option" but to reject Kadcyla at its current price.

The latest cancer drugs are monopoly products; patients have nowhere else to go. That is one of many reasons why the spectacle of big pharmaceutical companies wrangling with governments over the price of life-extending drugs is so unedifying. But we should not forget the background to this ghastly row: Roche is asking the National Health Service to spend a staggering £135m a year on a small group of patients while A&E departments buckle under demand and the number of people waiting for operations is at a six-year high.

twitter.com/@polblonde; politcalblonde.com

React Now

Latest stories from i100
Have you tried new the Independent Digital Edition apps?
iJobs Job Widget
iJobs General

IT Technician - 1st Line

£19000 - £21000 Per Annum: Clearwater People Solutions Ltd: ***EXCELLENT OPPOR...

Special Needs Teaching Assistant

£50 - £65 per day: Randstad Education Bristol: Special Educational Needs Teach...

Trainee Recruitment Consultant Birmingham

£18000 - £23000 per annum + Comission: SThree: The SThree group is a world lea...

Year 3 Teacher

£100 - £130 per day: Randstad Education Chelmsford: KS2 TeacherWould you like ...

Day In a Page

Read Next
Actor Brad Pitt  

The over-50s have the real voting and spending power — so why are we so obsessed with youth?

Stefano Hatfield
 

Daily catch-up: unbuilt buildings, the new Establishment and polling on Europe

John Rentoul
Indiana serial killer? Man arrested for murdering teenage prostitute confesses to six other murders - and police fear there could be many more

A new American serial killer?

Police fear man arrested for murder of teen prostitute could be responsible for killing spree dating back 20 years
Sweetie, the fake 10-year-old girl designed to catch online predators, claims her first scalp

Sting to trap paedophiles may not carry weight in UK courts

Computer image of ‘Sweetie’ represented entrapment, experts say
Fukushima nuclear crisis: Evacuees still stuck in cramped emergency housing three years on - and may never return home

Return to Fukushima – a land they will never call home again

Evacuees still stuck in cramped emergency housing three years on from nuclear disaster
Wildlife Photographer of the Year: Intimate image of resting lions claims top prize

Wildlife Photographer of the Year

Intimate image of resting lions claims top prize
Online petitions: Sign here to change the world

Want to change the world? Just sign here

The proliferation of online petitions allows us to register our protests at the touch of a button. But do they change anything?
Ed Sheeran hits back after being labelled too boring to headline festivals

'You need me, I don’t need you'

Ed Sheeran hits back after being labelled too boring to headline festivals
How to Get Away with Murder: Shonda Rhimes reinvents the legal drama

How to Get Away with Murder

Shonda Rhimes reinvents the legal drama
A cup of tea is every worker's right

Hard to swallow

Three hospitals in Leicester have banned their staff from drinking tea and coffee in public areas. Christopher Hirst explains why he thinks that a cuppa is every worker's right
Which animals are nearly extinct?

Which animals are nearly extinct?

Conservationists in Kenya are in mourning after the death of a white northern rhino, which has left the species with a single male. These are the other species on the brink
12 best children's shoes

Perfect for leaf-kicking: 12 best children's shoes

Find footwear perfect to keep kids' feet protected this autumn
Anderlecht vs Arsenal: Gunners' ray of light Aaron Ramsey shines again

Arsenal’s ray of light ready to shine again

Aaron Ramsey’s injury record has prompted a club investigation. For now, the midfielder is just happy to be fit to face Anderlecht in the Champions League
Comment: David Moyes' show of sensitivity thrown back in his face by former Manchester United manager Sir Alex Ferguson

Moyes’ show of sensitivity thrown back in his face... by Ferguson

Manchester United legend tramples on successor who resisted criticising his inheritance
Two super-sized ships have cruised into British waters, but how big can these behemoths get?

Super-sized ships: How big can they get?

Two of the largest vessels in the world cruised into UK waters last week
British doctors on brink of 'cure' for paralysis with spinal cord treatment

British doctors on brink of cure for paralysis

Sufferers can now be offered the possibility of cure thanks to a revolutionary implant of regenerative cells
Ranked seventh in world’s best tourist cities - not London, or Edinburgh, but Salisbury

Lonely Planet’s Best in Travel 2015

UK city beats Vienna, Paris and New York to be ranked seventh in world’s best tourist destinations - but it's not London