Delays in giving people the latest cancer medicines and unjustified price hikes for well-established treatments are disadvantaging patients, European experts have claimed.
The UK is particularly blighted by approval delays, a major conference heard.
Delegates at the European Cancer Congress 2017, in Amsterdam, The Netherlands, heard that cancer patients are living longer and in many cases the disease is becoming chronic rather than acute.
Dr Markus Hartmann, principal consultant of European Consulting and Contracting in Oncology, in Trier, Germany, said many patients are badly served because they do not have access to fair prices for drugs that help to extend life and improve quality of life.
While decisions over approving cancer drugs are made by the European Commission, decisions on reimbursement and pricing are taken at individual EU member state level, which results in major differences in the overall availability as well as the time taken before patients are able to obtain new medicines.
The researchers studied approval processes for the 48 new cancer drugs that were evaluated by the European Medicines Agency for use in the European Union between 2011 and 2015.
In 17 cases, approvals were based on a principal trial using overall survival as the main endpoint; in 19 cases, the approvals were based on trials using progression-free survival, while in 12 cases the decision was made on mainly single-arm trials, using overall response rate was the primary endpoint.
“These new drugs all show clinical benefit,” says Dr Hartmann. “Our data indicate in the overall survival group a median survival gain of 3.0 months, while in the progression-free survival group the median gain was 3.8 months. However, the trial design, trial endpoint and magnitude of effect is evaluated quite differently by the health technology assessment (HTA) authorities in the UK, France and Germany, even though they reviewed the same, or very similar, clinical data.”
In a second presentation, Dr Andrew Hill, senior research fellow in the Department of Pharmacology and Therapeutics, University of Liverpool, England, told the conference that some common cancer drugs, including generic cancer medicines, have increased by 1000% and more between 2011 and 2016.
“We were surprised to find several companies consistently raising the prices of cancer treatment,” he said. “Twenty treatments have shown rises of over 100% in the last five years, and in two – busulfan and tamoxifen – prices have increased by over 1000%. We have found that some companies take over the supply of some generic cancer medicines and then raise the price progressively.”
Paying these high prices puts undue strain on health systems, and the long-term result could be negative consequences for disease progression and survival. The researchers say that they are finding similar cases in other European countries. In Spain and Italy, failure to accept the high prices demanded for some generic treatments has led to warnings from companies that they could stop their supply.
“We hope that, by explaining what we have found in the UK, other European countries will take note and protect themselves against these kinds of price rises,” says Dr Hill. “At a time when cancer patients are living longer and better lives due to effective treatments, this situation is particularly worrying.”
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