Patients face being denied cancer cure in price row
A CURE for cancer is set to be denied to dying patients as officials and pharmaceutical companies argue over pricing.
NHS watchdog Nice will this week publish draft guidance expected to reject access to the first in a line of new CAR-T therapies – treatments which re- engineer a patient’s immune system to fight off cancer.
The technology, available in the US for the past year, offers the chance of a cure for children with leukaemia and adults with lymphoma.
It has been greeted by scientists as a genuine breakthrough which could transform cancer treatment, offering hope to patients with no options left. Even the head of the NHS has described it as one of the most innovative treatments ever seen.
But it comes at a very high price. In the US, CAR-T costs £375,000 per patient and that does not include the cost of hospital time, follow-up treatment and chemotherapy. The price makes it the most expensive ever created for a common disease.
Insiders say the cost to the NHS will be far lower, although the exact price is being kept commercially confidential.
But a draft appraisal by Nice, the National Institute for Health and Care Excellence, is expected to say the first of these treatments – a therapy called Yescarta made by drugs giant Gilead – is not cost-effective for use on the NHS.
Another draft decision – for Novartis’s CAR-T treatment Kymriah – is due in the coming weeks.
Experts hope the expected rejection is simply an ‘opening gambit’ in negotiations to drive down the price.
Simon Stevens, chief executive of NHS England, has said he wanted to see patients have access to CAR-T treatments – but that companies must ‘set fair and affordable prices’.
Experts say making CAR-T therapies is extremely complicated, which is why the cost is so high. It takes a team of scientists and a 17-day process simply to prepare the treatment.
But unlike conventional cancer drugs, which have to be given for years, it needs to be given only once.
Professor Alan Melcher of the Institute of Cancer Research in London said: ‘Companies are not just plucking a price out of the air, this is a really complicated process.’ But he added: ‘Negotiations will be going on; this is likely to be the opening gambit.’
Scientists have had extraordinary success in trials, putting patients into remission who had only months to live.
The latest Yescarta trial data showed 72 per cent of patients responded to treatment, and 51 per cent had no trace of cancer at all in their blood stream 15 months after treatment.
Patients treated with Kymriah showed similar results, with 52 per cent responding and 40 per cent completely clear of cancer after 14 months.
The treatments are expected to be licensed by the European Medicines Agency this month, making them available privately in Britain and elsewhere in the EU. But their use on the NHS relies on Nice, which is particularly concerned that the immune system could run out of control and attack the body.
‘Not just plucking a figure out of the air’