DRUG manufacturers have been accused of demanding too much money for life-extending medication after a second cutting-edge breast cancer treatment within a month was ruled to be too expensive for the NHS.
Perjeta, also known as pertuzumab, was yesterday turned down by the Scottish Medicines Consortium (SMC), which decided that despite the treatment extending patients' lives for an average of 16 months, it was not worth the price tag, which is £105,000 per six-month course.
The rejection comes four weeks after Kadcyla, another highly effective breast cancer drug, was rejected after experts baulked at its £80,000 cost.
The latest decision was met with dismay from cancer charities, which appeared to blame the drug's manufacturer Roche, rather than the SMC, for the ruling. Health Secretary Alex Neil called on the firm to lower its price.
It is understood that although Perjeta was turned down by the SMC in October last year due to its cost, Roche offered no price reduction in its latest application.
Despite the submission being considered under new rules designed to make it easier for drugs to be approved, the SMC panel said it could not justify its widespread use within the health service.
Roche responded by saying it was disappointed with the decision, which it claimed had been taken despite recent data showing "unprecedented" benefits of its product compared to drugs currently available.
Jayson Dallas, general manager of Roche, said: "This has changed the course of breast cancer treatment as we know it and we are disappointed that such innovation cannot currently be made available to patients via the NHS in Scotland."
It is estimated that within five years about 500 women with terminal HER2-positive secondary breast cancer, which is especially common in younger patients, would have been eligible for the drug, leaving the NHS with an increased annual bill of £30 million.
James Jopling, Breakthrough Breast Cancer's director for Scotland, said the rejection was devastating for cancer victims and that the current situation was unacceptable.
"When submissions for drugs costing £80,000 or £100,000 are going into a public health system, it's very difficult for them to be approved," he said. "The SMC are in almost an impossible position.
"Nobody benefits from these drugs being left on the shelf. If Roche want to see their drugs available, they need to get round the table with the Government and find a solution. We're not saying there is an easy solution, but there must be one."
Simon Skinner, from Bridge of Weir in Renfrewshire, lost his wife Sue to secondary breast cancer last month. Sue, 55, had been treated with Perjeta, which works in combination with Herceptin and is given as an infusion into the vein, while living in Ireland.
Mr Skinner said the drug produced dramatic results, reducing the size of his wife's tumour drastically while allowing her to enjoy a good quality of life. He said: "I'm bitterly disappointed in the decision, as other women will not be benefit from this drug as my wife did. Perjeta gave Sue extra quality time with her family and friends and with me, her husband. You can't put a price on that."
Patients in Scotland who want the drug will have to apply to their health boards on a case-by-case basis to have any hope of receiving it. Had it been approved, it would have been prescribed routinely.
Mr Neil said: "The SMC decision on pertuzumab will be disappointing for many, and like many patient groups I would encourage the drug's manufacturer to make it available at a lower cost to enable more people to have it as a treatment option in future."
Professor Jonathan Fox, chairman of the SMC, said: "Despite the very strong support from patient groups and clinicians for pertuzumab and applying as much additional flexibility as we could, the committee was unfortunately not satisfied that it would be a cost effective use of NHS Scotland resources."
He added:"NHS Scotland does not have infinite resources and companies are well aware of this. We would encourage the manufacturer to make a resubmission for pertuzumab, reflecting on the issues raised by SMC."
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