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Roche - “time running out” in UK drug pricing debate

Says DH needs to clarify VBP and fate of cancer drugs fund or patients will lose out

Roche Basel Switzerland

The UK Department of Health (DH) needs to provide details of its value-based pricing (VBP) scheme soon, or patients will face problems gaining access to cancer medicines, according to Roche.

Speaking at the National Cancer Intelligence Network (NCIN) Cancer Outcomes Conference in Birmingham, the pharma company's UK director of health economics and strategic pricing Gavin Lewis outlined the implications of the planned introduction of VBP in 2014, just as the current cancer drugs fund (CDF) is to cease operating.

As the situation stands, he said, this would deny patients access to such drugs as Roche's multi-cancer treatment Avastin (bevacizumab), which is only available on the NHS through the £600m CDF as it is not recommended by the National Institute for Health and Clinical Excellence (NICE).

The loss of the fund, and the uncertainty over whether Avastin and other cancer drugs such as Merck KGaA's Erbitux (cetuximab) and Roche's MabThera (rituximab) would be eligible for use on the NHS through VBP, could mean patients lose on medicines that become standard care over the next 18 months, according to Lewis.

Roche in particular stands to lose out if the cancer drugs fund is lost with no replacement, having two of the fund's top five most requested drugs from April 2011 to January 2012.  

“The reality is there is still silence [from the DH], and we'll soon be into 2013,” Lewis said. “And if you really want to have continuity of access to these cancer drugs and still have VBP at the end of 2013, then you could start saying it's too late to start that process.”

“It's at least 12 months since the government responded to Roche and that's the last official opinion we've had from the DH about how they're going to go about implementing it and addressing all these questions,” he told PMLiVE.

“And we're now 18 months from VBP being implemented and CDF ending and that's creating a lot of uncertainty about what evidence we need to collect in order to effectively submit our dossiers around VBP, and time is running out.”

This 'uncertainty' is likely to continue until the actual negotiations between industry and the Department of Health take place, suggested Lewis, with September, 2012, seen as the likely date for these to commence, according to both Lewis and trade body the Association of the British Pharmaceutical Industry (ABPI).

Commenting on the date of negotiations, the Department of Health said it expects talks will take place before the end of 2012.

NICE's Zelboraf decision 'highlights VBP challenges' 

Lewis's comments coincide with the release of draft guidance from NICE that turned down the use of Roche's Zelboraf (vemurafenib) for the treatment of unresectable locally advanced or metastatic BRAF V600 mutation-positive melanoma on the NHS.

The decision underlined the need for a rethink over VBP, according to Roche UK's managing director John Melville, who said NICE was basing its decision on a series of “key factors” that constitute the future VBP scheme.

“The draft recommendation that results from the use of the existing NICE methodology highlights a need for change in order for value-based pricing to meet the Government's stated access to medicines objectives,” he said.

“Whilst patients can continue to access Zelboraf through the cancer drugs fund, the fact the CDF was only intended as a bridge to value-based pricing, the outcome of this NICE decision causes me great concern in relation to long term patient availability.”

15th June 2012

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