Pharma calls for NICE overhaul as special cancer drugs fund nixes meds

ABPI's Paul Catchpole

Drugmakers bristled last week when they heard which drugs might lose coverage from England's Cancer Drugs Fund (CDF), which pays for meds rejected by the country's cost-effectiveness gatekeepers. Now, the industry is demanding an overhaul--not just of the CDF, but of the National Institute for Health and Care Excellence (NICE) system for assessing cancer treatments.

As the Financial Times reports, CDF critics and drug companies both want the British cost watchdog to rethink its cost calculations on cancer medicines. If NICE was more flexible in recommending expensive, late-stage cancer treatments, the CDF wouldn't be necessary, they say. Companies such as Novartis ($NVS), Sanofi ($SNY) and Eisai have already been informed that their treatments will be eliminated from the fund's coverage.

Paul Catchpole, director of value and access at the Association of the British Pharmaceutical Industry (ABPI), said the industry was "very disappointed" in how NHS England went about its review of cancer treatments. "Such a re-evaluation process would not be necessary in the first place if NICE quickly evolves the way it evaluates cancer medicine as part of more fundamental reforms," Catchpole told the FT.

Drugmakers are also rallying against the CDF's decisions on particular meds. Eisai CEO Haruo Naito has said publicly that he'd fight back after news that Halaven, the Japanese pharma's breast cancer drug, would be crossed off the fund's coverage list. After learning that its Afinitor drug would likely be dropped, Novartis said the NHS' assessment process was "unacceptable as it is insufficiently robust and transparent," and the cost portion of the evaluation "does not reflect the true value of cancer drugs."

Drugs such as Sanofi's Jevtana for second- and third-line prostate cancer and Zaltrap for advanced colon cancer will also be left off the list. Other drugs up for reassessment include Roche's ($RHHBY) new breast cancer meds Perjeta and Kadcyla; Pfizer's ($PFE) leukemia treatment Bosulif and lung cancer drug Xalkori; and Bayer and Amgen's ($AMGN) colon cancer drug Stivarga. The full list of rejected treatments is expected to be released sometime Monday, the FT reports.

The whole process is a consequence of CDF's budget overruns. British officials said last year they expected the fund to exceed its £200 million annual budget ($422 million) by £100 million by the end of the fiscal year, and the government promised an additional £160 million infusion to keep the CDF ship afloat. Along with the cash, the government granted the fund power to reassess its drug list, to whittle down its list of 42 meds to cut costs and make room for new products.

"We need to get maximum value for every pound we spend," CDF Chairman Peter Clark said last week. "We can no longer sustain a position where we are funding drugs that don't offer sufficient clinical benefit when drugs that will do more for patients are coming on stream."

- check out the FT article

Special Report: Top 10 best-selling cancer drugs of 2013