News

Five cancer drugs back on NHS list after deals with drug companies

BMJ 2015; 351 doi: http://dx.doi.org/10.1136/bmj.h5985 (Published 06 November 2015) Cite this as: BMJ 2015;351:h5985
  1. Nigel Hawkes
  1. 1London

Five cancer drugs have been reinstated on the list paid for by England’s Cancer Drugs Fund, after manufacturers provided discounts to make them more affordable.

The fund faces rising costs, and in September it announced the removal of 16 drugs used in 23 treatments, in an attempt to balance its books.1 Thanks to the new deal it has now been able to reinstate five, used in seven treatments, reducing the number of patients in England who would have been denied access to the drugs from 5500 to 4100.

Among the reprieved drugs is trastuzumab (Kadcyla), a Roche product capable of extending the life of patients with advanced breast cancer by six months. Its original price was £90 000 (€130 000; $140 000) a year, well above the normal threshold for drugs used at the end of life of around £50 000 per quality adjusted life year. The size of the discount offered has not been disclosed.

The other reinstated drugs are bevacizumab (Avastin), but only for cervical cancer, not for bowel or breast cancer; bosutinib (Bosulif) for chronic myeloid leukaemia; ibrutinib (Imbruvica) for chronic lymphocytic leukaemia and for mantle cell lymphoma; and brentuximab (Adcetris) for two types of lymphoma.

Peter Clark, who chairs the Cancer Drugs Fund, said, “In some cases the drugs we proposed to remove were the least effective on the list, and we could not continue to fund them. In others they were simply too expensive, so we are pleased the pharmaceutical companies worked with us, reducing their prices, ensuring these treatments remain available to patients.”

The charity Breast Cancer Now organised a petition backed by 42 000 signatures asking Roche to reduce the price of trastuzumab. Its chief executive, Delyth Morgan, said, “It’s encouraging to learn that Roche and NHS England have been able to come to a deal, but patients relying on other delisted drugs such as the breast cancer drug Avastin for future treatments will no doubt be devastated. There’s a bigger problem with our drug access and pricing system that will not go away.”

Richard Erwin, managing director of Roche UK, said, “This must be the last time that patients are subjected to the uncertainty of cancer drug delistings.”

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Cite this as: BMJ 2015;351:h5985

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