Pharma and NICE must end games of ‘one-upmanship’
pharmafile | November 10, 2008 | News story | Sales and Marketing | NHS, par
Patient groups are calling on a pharmaceutical company to reach a compromise with NICE over a bone marrow cancer drug.
Celgene's Revlimid (lenalidomide) has been rejected in draft NICE guidance on the grounds that it is too expensive.
Myeloma UK, Macmillan Cancer Support and Leukaemia CARE have criticised the decision, and accused NICE and Celgene of playing a "game of professional one-upmanship".
The alliance of patient groups is calling for a mature relationship between NICE and the industry, and asking for change on both sides to break a deadlock which is familiar from many previous reviews of cancer drugs. In this sense, the triumvirate has broken away from the usual patient group tactics of concentrating their attack on NICE for its methods of calculating cost-effectiveness.
The charities are seemingly responding to the changing nature of the debate, particularly in the wake of comments made by NICE chairman Prof Sir Michael Rawlins. He recently broke from a long-standing habit of not discussing pharma's prices with some pointed remarks to The Observer newspaper.
"We are told we are being mean but what nobody mentions is why the drugs are so expensive," he said, adding that kidney cancer drugs could be produced for a tenth of the cost. He acknowledged pharma's need for profit-making, but said companies need to consider lower prices.
Eric Low, chief executive of Myeloma UK, has expressed disappointment that Revlimid has been rejected, despite NICE admitting it is effective, and has demanded both sides find a solution.
He said: "There is now a window of opportunity for NICE and the company to demonstrate they are capable of dealing with a complex appraisal and righting this wrong decision for patients."
The patient groups say the manufacturer, NICE and the Department of Health should be able to work out how to make this revolutionary new drug available to patients.
A risk-sharing system, similar to the one offered by Janssen-Cilag for its bone marrow drug Velcade, is one of the compromises that could be reached. Velcade costs the NHS around £18,000 per patient, but this is refunded by Janssen-Cilag if patients show minimal or no response.
Andrew Robertson, general manager at Celgene, said: "Celgene is committed to working with NICE, the Department of Health and the myeloma community to ensure that the final NICE guidance will be positive and patients with myeloma can have the opportunity to live longer with their cancer controlled."
The Institute has said it will consider any pricing scheme proposed by the manufacturer once they have been reviewed and considered suitable for the NHS, by the Department of Health.
NICE will now review the feedback it receives from a three-week consultation period and make its final recommendation in January 2009.
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