The drugs giant Roche has been accused of blocking hundreds of terminal cancer patients from receiving a life-extending drug, by refusing to cut costs to make it affordable for the NHS.
Roche’s drug Kadcyla can extend life by six months longer than the next best treatment, but will not be available on the NHS because of its £90,000-per-patient price-tag, the National Institute for Health and Care Excellence (NICE) confirmed today, in final draft guidance.
The drug, which is recommended for women with HER2-positive breast cancer whose treatment with other drugs and chemotherapy has failed, is available in England through the £200m Cancer Drugs Fund, but is only released on case-by-case basis.
Had the drug been made available on the NHS, it would have reached around 1,500 women.
Sir Andrew Dillon, chief executive of NICE, said he was “really disappointed that Roche were not able to demonstrate more flexibility to help us make a positive recommendation.” However, the Swiss pharmaceutical firm, which recorded profits of £7.4bn last year, hit back saying that it had offered a “significant discount”.
Dr Jayson Dallas, general manager of Roche Products Ltd accused NICE of an “incredible injustice” which was “tantamount to turning the clock back in cancer research and development.”
Breast cancer charities expressed disappointment at NICE’s decision, but also criticised Roche for the high price-tag.
Sally Greenbrook, senior policy officer at Breakthrough Breast Cancer said that Kadcyla was “incredibly expensive”.
“NICE have gone over and above their usual processes to try to approve it but despite this, and the discount offered by the manufacturer, the revised price for Kadcyla is still too high to be considered cost effective,” she said.
“We believe all cancer patients should be able to access the best possible treatment but for this to happen within the confines of the NHS budget, prices set by the pharmaceutical industry for impressive, life-extending drugs such as Kadcyla must come down. It’s impossible to put a price on life’s precious moments. But it’s not impossible to put a fair price on drugs.”
Dr Emma Pennery, clinical director at Breast Cancer Care, said it was “worrying” that every drug appraised by NICE for terminal breast cancer patients in the past three years had been rejected. She called on NICE, the Department of Health and the pharmaceutical industry to work together on “a new way forward”.
The Cancer Drugs Fund, which exists to pay for cancer drugs which the NHS does not ordinarily provide for cost reasons, is set to terminate in 2016.
A spokesperson for Roche said that a discount of 60 per cent would have been required to meet NICE’s requirements for cost-efficiency – a rate which was described as “unrealistic”. The company could not disclose the actual rate of discount it had offered NICE.
According to Rohce, Kadcyla took 15 years to develop. It is already routinely available in several European countries.
Dr Pennery said that, as well as extending life, Kadcyla also had advantages over other drugs in terms of reducing side-effects and improving quality of life for terminally ill patients.
“Patients having Kadcyla will have incurable disease. Knowing, that time becomes very precious,” she said. “Those extra six months might allow them to spend more time with loved ones, with families.”
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