Roche and NICE leaders agree: cancer shouldn’t be a special case

Roche chief executive Severin Schwan says Europe must catch up with the lead set by the US FDA in accelerating approval of new drugs – but says the problem of regulatory delays is most acute in China and developing nations.

These were among the most eye-catching remarks made by Schwan during his keynote address to the FT Pharmaceutical and Biotech conference in London.

Schwan also addressed the hot topic of drug prices and market access, saying it was exploring novel approaches, including ‘differential prices’ for Avastin in Italy, and collaboration with health insurers in China to extend access to cancer treatments.

He also discussed the UK market – one of the most important markets in Europe, but also presenting some of the biggest barriers to market access.

In September, Schwan lashed out and called the UK’s system ‘stupid’ after Kadcyla and Avastin were marked for de-listing from the Cancer Drugs Fund (CDF).

Choosing his words more carefully this time, Schwan nevertheless made his feelings clear about the access problem – saying the National Health Service (NHS) decision makers were too dominant.

“In the UK, you have one perspective, the payers, the NHS, NICE. They believe they have the right answer,” he commented.

“There is no objective right price for the value of life. You can’t have one perspective where judge and jury are the same person.”

Schwan said the solution was to allow all stakeholders to have a say, adding that ‘more creative’ approaches to pricing, such as different prices for different indications, were needed.

The debate came just two weeks after Roche agreed to a price cut on its breast cancer drug Kadcyla, which means it will remain on England’s CDF. However today has seen NICE reject Kadcyla, saying it has not been offered the same discount, and that the price is still too high.

The Roche CEO conceded that the decision on healthcare funding was ultimately a political one, but questioned the need for a dedicated CDF, saying it was a ‘funny concept’.

The fund is indeed unique to England, and was created because NICE so frequently rejects new cancer drugs, but is itself now unsustainable, with a growing budget overspend.

The UK government is currently struggling with how to change its system – pharmaphorum reported just last week that Prime Minister David Cameron has taken a personal interest in the future of the CDF.

Also speaking at the FT conference was NICE’s chairman Dr David Haslam. Asked if he thought cancer drugs should be considered a special case, he answered “I don’t know” – but went on to say that he believed that cancer should not be considered more important than other disease areas, such as mental health.

“I certainly feel cancer shouldn’t be treated any differently. You’re just as dead from suicide as you are from cancer,” he said.

Haslam said he recently met patients with the degenerative disease motor neurone disease, who asked him why cancer was considered a special case, and added that his impression was that fear of developing Alzheimer’s was now growing compared to fears about cancer.

Budget holder NHS England has pledged to have a new CDF in place by April 2016, but charities and others are concerned that time is running out for a sustainable and fair system to be established in time.

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