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state healthcare.
Significantly, NICE also thinks Bayer's Nexavar is too
expensive - highlighting the common concerns about
costs shared by healthcare authorities in different parts
of the globe.
Such tough calls are inevitable when budgets are
limited, according to NICE chairman Mike Rawlins,
who says it is time to challenge drug companies about
the high prices they seek for products that sometimes
offer only modest benefits.
$85 BLN SALES BY 2016
The debate over how to price cancer medicines
matters intensely for the pharmaceuticals industry and
society at large.
Cancer is a leading cause of death worldwide,
accounting for 7.6 million deaths in 2008 and predicted
to top 13 million in 2030, according to the World Health
Organisation. Some 70 percent of deaths occur in lowand
middle-income countries.
For drugmakers, the disease is a rich seam of sales
and profits. Cancer medicines overtook cholesterol
fighters as the biggest-selling selling prescription drug
class five years ago and sales are set to hit $85 billion
in 2016, up from $58 billion last year and a mere $8
billion in 2000, according to consensus forecasts
compiled by Thomson Reuters Pharma.
Cancer is particularly attractive commercially as
patents expire and profits wane on drugs in other
areas.
Privately, though, even some drug company
executives wonder if the industry will be charging such
high prices in a few years time.
The price tags on a flurry of new entrants have
certainly pushed the envelope, with Bristol-Myers
Squibb's melanoma treatment Yervoy costing
$120,000 for a four-infusion course and Dendreon's
Provenge for prostate cancer priced at $93,000 for a
three-dose course.
In the United States, some cancer patients have
abandoned medical care because of their bills or else
face a significant risk of bankruptcy, according to
studies presented at the American Society of Clinical
Oncology last year.
Europe's more socialized healthcare system creates
different strains. Cash-strapped governments have
slashed drug prices, racked up close to $20 billion in
Reuters General/ - Article, Dom, 01 de Abril de 2012
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unpaid bills for treatments and, crucially, are becoming
increasingly reluctant to pay for innovative new drugs.
Andrew Witty, chief executive of GlaxoSmithKline,
says European governments are making a false
economy by delaying the introduction and
reimbursement of promising new treatments,
especially for cancer, in their short-term drive to save
money.
Pfizer CEO Ian Read told Reuters last month there
was a serious "disconnect" between the marketplace in
Europe and the desire of governments to sustain a
vibrant research base. "Europe is not paying its fair
share of innovation," Read said.
SMALLER, SMARTER TRIALS
From his office at the ICR behind the Marsden hospital
in Sutton, Workman has an unusual vantage point
across the cancer landscape. With a staff of 160, his
team is as large as the oncology departments of some
Big Pharma companies and in the past six years has
discovered 16 innovative cancer drugs.
Thanks to rapid advances in genetics, scientists now
have a fundamental understanding of the workings of
tumor cells that did not exist in the days when toxic
chemotherapy was the only tool in the medicine chest.
However, the lion's share of the $1 billion or more it
takes to bring a new drug to market is not chewed up
by scientists working in the lab but by the cost of
running clinical trials. It is the high failure rate of these
studies that pushes up the price of those few drugs
that do succeed.
Still, there is light at the end of the tunnel. The ability to
target modern cancer treatments to the genetic profile
of individual patients means trials can now be
designed with far fewer patients, reducing costs
dramatically.
Workman predicts that in five years the average
success rate for a cancer drug starting out in
early-stage clinical development will be 50 percent, up
from 5 percent now.
"It is no longer a lottery," he says.
"Trials in future will be smaller, quicker and cheaper.
The failure rate will go down and the economic model
will rebalance. That means the R&D costs that
companies need to recoup when they sell a new drug
will come down and those savings should be passed
on to the patients."
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