Breast cancer patients threatened by patents

ATOTAL of 453km. That’s how far Claudette Moore will have to drive to prolong her life if her rare, aggressive form of breast cancer returns.

The only public hospital in South Africa that provides the cancer-fighting drug Moore needs is located in the Northern Cape: Kimberley Hospital.

And the 46 year old, who is HER2-positive and positive for oestrogen receptors and progesterone receptors, lives in the Vaal Triangle. Nor can she afford the hundreds of thousands of rand it costs to obtain the expensive medication, Herceptin

“My cancer can come back tomorrow. What do I do then? Move to Kimberley to get the drug I need because it’s not available in Gauteng? My husband works here. Or must I drive there every three weeks while I am sick?” she asks.

This week, the Competition Commission announced it has launched a wide-ranging probe into Swiss pharmaceutical giant Roche and its USbased biotechnology company, Genentech “who have and continue to engage in excessive pricing, price discrimination and/or exclusionary conduct in the provision of breast can- cer medicine in South Africa”.

Breast cancer treatment is unaffordable in South Africa and many medical aid schemes refuse to pay the treatment based on cost, says the commission.

“The price of Herceptin is R500 000 for a 12-month cycle of treatment in the private sector,” explains Salome Meyer of the Cancer Alliance.

“In the public sector it’s round R212 000 and an offer is on the table for R125 000. One has to ask why the price difference … Who is benefiting? Certainly not the patients.”

Only Roche’s branded versions of Trastuzumab, sold locally under the names Herceptin and Herclon, are available. The World Health Organisation recommends it as an essential medicine.

“What Roche is doing is a game of money,” believes Moore. “It’s disgusting that they watch people die so they can get rich.”

At Charlotte Maxeke Johannesburg Academic Hospital, Moore was put onto a chemotherapy agent called the “Red Devil” because of its colour and aggressive method. For the next 10 years, she will be on hormone therapy.

“I’m a 46 year old with fullblown menopause and I can’t work.

“If I had Herceptin maybe I wouldn’t need all this medication. My odds would have been much better because it fights the rare, fast-growing cancer I have.”

Breast cancer is the leading form of cancer affecting women in South Africa.

Ntokozo Dlula, a patient navigator and senior counsellor at Helen Joseph Hospital, deals with patients who are HER2-positive but cannot get treatment because of the unavailability of the drug.

“Sometimes you don’t want to tell them, because they get discouraged.

“Even if they get Red Devil, they know it doesn’t work as well as the Herceptin. It’s hard,” she says.

Breast cancer patients in both the private and public sectors are unable to get treatment, says the commission.

Roche holds a composition patent for its Trastuzumab product, Herceptin, in South Africa, which expires in 2020.

Genentech, which provides exclusive marketing rights to Roche for the product, also holds a patent covering combinations of the drug and other chemotherapeutic agents which could block pre-clinical work on a bio-similar product until 2033.

The commission has also started an investigation against pharmaceutical giant Pfizer for suspected excessive pricing of lung cancer medication, and Aspen Pharmacare Holdings for suspected abuse of dominance by charging excessive prices for medication to treat chronic lymphocytic leukaemia, Hodgkin lymphoma, and non-Hodgkin lymphoma.

In a February statement, Roche outlined that it remained fully committed to working with patient groups, the national Department of Health and others to urgently reach a solution which improves the care and outcomes of women with HER2-positive breast cancer in South Africa.

“Our aim is for every person who needs Roche medicines to be able to access and benefit from them.”