There’s a big battle ahead on expensive cancer drugs

AFTER three doses of the pioneering cancer drug pembrolizumab, Vicky Phelan’s cancer is in remission, and there’s every reason to hope that her original prognosis of six to 12 months will be considerably prolonged.

Vicky’s change of fortune gives hope to those with the same sort of cancer, but it also reopens the debate about how prohibitively expensive drugs can be made available to those who need them. Former US President Jimmy Carter credits pembrolizumab with making melanoma disappear from his brain, but the drug doesn’t come cheap. It costs about €8,500 per month, so the only way for most of us to access it is through clinical drug trials.

In this country pembrolizumab is only licensed for a small number of cancers. Vicky discovered it on the internet and raised a lot the money through crowdfunding. The morality of forcing a terminally ill patient to hustle for a drug that could buy them precious time is questionable. We should not have to put a price on life, yet the staggering cost of cutting-edge drugs puts public health officials in that position.

Last year, after a bitter row, Simon Harris agreed to Statefunded access to orkambi for cystic fibrosis patients. The manufacturer sought €159,000 per patient per drug which, according to the HSE, would cost the State €400m over five years. If pembrolizumab proves effective against a range of cancers, the Government could face a second public controversy where it has to balance the demands of patients desperate for treatment against the demands of profiteering pharmaceutical giants.

And with the formidable Vicky Phelan on one side, it’s not hard to see where the balance might fall.