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Roche’s breast cancer drug too expensive for NHS use

But pharma company says UK Government dithering on Perjeta patient access scheme

Roche's breast cancer drug too expensive for NHS use

Roche's ambitions for breast cancer drug Perjeta were hit today when draft guidance was published advising against use of the drug on the NHS in England and Wales.

The UK's National Institute for Health and Care Excellence (NICE) determined that Perjeta (pertuzumab) was not value for money at its current price when used as a treatment for a type of advanced breast cancer, especially when other medicines for this indication, such as Roche's own Herceptin (trastuzumab), were cheaper.

This was partly due to the limitations in the clinical trial data provide by Roche, which meant NICE was unable to predict how long the drug might extend people's lives.

“The appraisal committee couldn't be sure of the benefits of pertuzumab,” confirmed NICE's chief executive Sir Andrew Dillon.

“The main clinical trial did not reflect current medical practice in the UK and despite the research data suggesting the treatment could help delay the growth and spread of the disease, the evidence was not robust enough to confirm for how long pertuzumab may actually extend people's lives.”

Roche had even determined that drug would not pass NICE's assessment, according to Sir Andrew, who said “the manufacturer estimated that the treatment would not be considered cost-effective for the NHS”.

Government dithering on discounted price.

The pharma company's resignation is likely down to the Department of Health's (DH) pending decision on a patient access scheme proposed by Roche, which would mean that Perjeta was offered to the NHS at a discount to its standard price of about $190,000 for an 18-month course.

“The DH has not made a decision on a patient access scheme proposed by Roche, despite having had several weeks for review,” said the company.

“The scheme, already given the green light by NICE's own independent group of experts, is with the DH for ministerial ratification, but has not materialised. With the Cancer Drugs Fund in England due to come to an end in six months, this inability to make a decision casts a looming shadow of doubt over the future availability of this life extending personalised cancer drug.”

Roche has faced several NICE rejections in cancer in recent years, mainly related to Avastin (bevacizumab) in different indications, and has come to rely on the Cancer Drugs Fund to provide patients in England with access to drugs not approved by NICE.

However, this scheme is due to end in early 2014 when the UK introduces a new value-based system of drug pricing, and Roche has repeatedly raised concerns about the future of drugs currently funded through the Cancer Drugs Fund.

The latest NICE guidance on Perjeta is yet more evidence that the reimbursement system in England Wales needs to improve and address the concerns of both industry and patients, according to Roche, especially considering that six cancer drugs have failed to win NICE backing since 2011.

“This is a poor and unacceptable record which serves to highlight some serious flaws in an aged and creaking system,” said the company.

NICE has now opened a consultation on the draft Perjeta guidance, during which organisations including charities, patient groups, NHS trusts and drug manufacturers being asked for their views up until August 28.


Article by
Thomas Meek

6th August 2013

From: Sales



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