It’s #WorldCancerDay, lets fight for affordable cancer drugs
04 February 2018
Access to cancer drugs plays a big part in the fight to save millions of preventable deaths each year. But as our chronically underfunded NHS buckles under pressure this winter, billions of pounds are handed over to pharmaceutical companies every year for overpriced medicines. The pharmaceutical industry has been dubbed as one of the most profitable in the world with profit levels on par with the banking industry and double that of oil and gas. But the sky-high prices charged for life-changing and life-saving medicines has serious consequences for patients both here in the UK and around the world.
Last year I met Emma, from the patient-led campaign group Just Treatment, who is campaigning against high drug prices. Diagnosed with secondary breast cancer, she launched and won a campaign to lower the price of cancer drug, palbociclib, so that it could be approved for use on the NHS. This highly effective drug can stop the growth of advanced breast cancer for an extra 10 months but had previously been unavailable on the NHS because of its expensive price tag. The drugmaker, Pfizer wanted to charge the NHS £38,482 per patient per year for this drug (£140 per pill!). But it is estimated that the drug can be profitably produced for £1 per pill. Deals like this and also last week's approval of another breast cancer, pertuzumab are great news for women with advanced breast cancer. But these deals are negotiated behind closed doors and so we don't know how much the companies are charging the NHS. With pertuzumab, the drug was approved for England, but is still unavailable in Scotland, Northern Ireland and Wales and so the problem of high prices locking patients out of vital medicines needs to be urgently addressed.
Expensive medicines puts pressure on already squeezed NHS budgets
Between 2011 to 2016, NHS spending on medicines has increased by £3.8bn, that’s a whopping rise of 34% over just a five year period and it’s twice the NHS budget deficit. Faced with soaring prices, the NHS is increasingly having to ration or reject new drugs.
The NHS rejects over a quarter of all new cancer drugs over cost-efficiency concerns, leaving many cancer patients unable to access the treatment they need. This is doubly-outrageous when you consider the public purse makes significant contributions to the research and development of drugs. Publicly funded research and public research institutes have been responsible for major medical breakthroughs but the discovery gets bought up by drug companies who then charge extortionate prices back to the NHS for the drugs. In 2016, the NHS spent over £1bn on drugs that were developed with publicly funded R&D. Taxpayers end up paying twice - first for the research and then in the high prices charged to the NHS.
Abiraterone, a highly effective drug to treat advanced prostate cancer, was discovered at the publicly-funded Institute of Cancer Research. The drug was eventually bought up and marketed as Zytiga by Johnson and Johnson. But at its launch, the high price of the drug led to repeated rejections for not being cost-effective. After five years of negotiations, spanning two reviews and with pressure from patient groups, the price of the drug was lowered and eventually recommended. But only after thousands of advanced prostate cancer patients could not access the drug over that five year period - even though taxpayers had contributed to its discovery.
How can drug companies get away with ripping us off like this?
Drug companies are able to charge high prices for new drugs because of patents, which in effect creates a legal monopoly as no other company can make or sell that drug during the patent period. Drug companies defend the high prices that they charge by claiming they need to recoup their research and development costs (R&D). But there is no publicly available information on R&D costs for medicines as the industry guards this information with secrecy. What we do know is that whatever their R&D costs, nine out of the top ten pharmaceutical companies spend more on marketing than on R&D. And a recent study published in the BMJ Global Health produced reliable estimates for the generic prices that could be achieved (even with a competitive profit margin) for a wide range of medicines. Its results showed that 77% of the 277 drugs in study had lower estimates than current prices in the UK.
In spite of claims about recouping costs, frequent drug pricing scandals indicate that prices seem to be set by what the market can bear. Last year, the Competition and Markets Authority fined the drug companies, Pfizer and Flynn Pharma nearly £90 million for charging excessive prices to the NHS for an anti-epilepsy drug. The drug price was hiked up by an unbelieveable 2,600% overnight in September 2012 which meant that the NHS expenditure on the drug increased from about £2 million a year in 2012 to about £50 million in 2013.
But its not just patented drugs that are keeping prices high, prices are rising even with drugs that are no longer under patent (generic drugs). Last year research by professor Andrew Hill, senior research fellow in clinical pharmacology at the University of Liverpool, showed that out of 89 cancer medicines in the UK, 21 showed price rises from 2011 to 2016. 14 of these were generic cancer drugs that had price hikes of more than 100% over the five year period.
Globally, the problems of high drug prices and access to essential treatment are replicated with greater magnitude especially in low and middle income countries. Cancer is the second leading cause of death globally and approximately 70% of deaths from cancer occur in low- and middle-income countries. The demand for cancer treatment is not being adequately met and high drug prices is a significant barrier for access to essential cancer treatment.
Globally, the problem of hyper-inflated drug prices are bringing governments and public health authorities to their knees. And there is a mounting recognition that something has to be done. In 2016, UN High Level Panel on Access to Medicines acknowledged that the current profit-driven R&D model is not working and instead called for alternative models that prioritise public health over corporate profits.
As pharmaceutical companies reap dizzying levels of profits, the human and social cost is eye-watering. There can be nothing more heartbreaking than knowing there is a drug that has been discovered that can alleviate your suffering or even cure you completely and yet you can’t get your hands on it because of its extortionate price tag. This cannot continue. People across the world are calling for change, we just need our governments to stop tolerating a system geared for profit rather than public health and do something about it.
What can you do?
The UK government spent £2.3bn on health R&D in 2015 and should introduce measures to ensure the public benefit from public investment in researching effective and innovative drugs. Email your MP to call on the Secretary of State for Business, Energy and Industrial Strategy to attach conditions on public funding for health R&D to ensure drugs produced from publicly funded research are both affordable and accessible - both here and across the world.