Better, cheaper cancer drugs ‘may be too late’
John Crown said it is likely that the new drugs will be approved sometime this year, but it could be too late for a small number of patients, who need them now.
Prof Crown said cancer specialists have to give patients another drug, called ipilimumab, also known as ipi, which is not as good; is more toxic; and just as expensive as the new drugs.
The HSE is assessing the cost of providing the two cancer drugs — pembrolizumab (pembro) and nivolumab (nivo) — which are already available elsewhere, including in Greece.
The supply of pembro, under a compassionate-use programme, has already ended. A similar access programme, for nivo, is due to end next week.
Experts have found that the drugs are successful in treating cancers, including melanoma, kidney tumours, and certain types of lung cancer.
The HSE says the drugs are being carefully considered, under a process of health-technology assessment, to determine value-for-money and patient benefits.
Pembro has an estimated five-year cost implication of €64m to the State, at the price being sought by the company.
“The single, biggest barrier to new drugs approvals in Ireland is the high prices that manufacturers are seeking to charge,” the health authority stated.
Prof Crown said cancer specialists are giving patients ipi, which is not as good as the newer drugs, and is just as expensive.
“The new drugs are not only more active, in terms of their anti-cancer effect, but they are also safer,” he said.
“I am seeing patients, right now, and I am telling them ‘there is a drug I want to give you, but I am going to give you something that is not as good and is less likely to work and, by the way, will cost the health service just as much’.” He has a patient, with melanoma, who was given pembro when ipi failed, and is now in remission for two years.
Prof Crown said that up to 150 people die from melanoma every year. “There is good evidence that we can make those people live a lot longer and we can possibly cure a large proportion of them”.
Consultant oncologist at the Midland Regional Hospital, Tullamore, Kyran Bulger, said the initial pricing for pembro was €134,000 per patient per year.
Dr Bulger, who was speaking on RTÉ radio yesterday, said he had used pembro to treat two patients, who had just months to live, and described the results as “spectacular.”
He had exhausted all options and gave the drug “in desperation”. Now, several months later, the cancer has disappeared. “We are clinicians. We look after people — it’s desperate when you can’t do anything for them,” said Dr Bulger.
Fianna Fail health spokesman Billy Kelleher said it is not good enough that medication that could save lives is being denied.
The Irish Cancer Society said it does not comment on drugs under negotiation between ‘payers’ and pharmaceutical companies.
