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Drug chief angry at medicine cost

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Drug chief angry at medicine cost

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NICE advises on which drugs should be bought by the NHS

 

The head of a government health advisory body has accused pharmaceutical companies of driving up the price of medicine.

 

Professor Sir Michael Rawlins says drugs are expensive because of "perverse incentives" in the pharmaceutical industry.

 

The chairman of the National Institute for Clinical Excellence (NICE) made his comments to the Observer newspaper.

 

NICE has recently been criticised for failing to approve kidney cancer drugs.

 

Double-digit growth

 

It advises the NHS in England and Wales on which drugs to buy.

 

Sir Michael said: "We are told we are being mean all the time but what nobody mentions is why the drugs are so expensive.

 

"Pharmaceutical companies have enjoyed double-digit growth year on year and they are out to sustain that, not least because their senior management's earnings are related to the share price.

 

 

Pharmaceutical companies make a huge investment into public health when they develop a new medicine.

Association of the British Pharmaceutical Industry

 

"It's not in their interests to take less profit, personally as well as from the point of view of the business. All these perverse incentives drive the price up."

 

Sir Michael said companies set high prices as a means of "cushioning" against the time when their products are no longer protected by patents and competitors can then make cheaper versions.

 

He also said: "The other thing we have to pay for is the costs of marketing. Marketing costs generally are about twice the spend on research and development."

 

'Huge investment'

 

A spokeswoman for the Association of the British Pharmaceutical Industry said drugs companies insist they are committed to cutting prices.

 

"Of course, pharmaceutical companies make a huge investment into public health when they develop a new medicine.

 

"It costs on average £550m, and takes more than 10 years, to bring each new treatment to patients.

 

"Naturally companies will look to recoup such costs through the final price."

 

Professor Sir Michael Rawlins is angry at the drugs companies

 

BBC health reporter James Cook said drug companies also claim that without the vast sums they invest in research and development, many life saving drugs would not exist at all.

 

There are treatments for advanced kidney cancer that are widely available elsewhere in Europe, but NICE decided that four drug treatments for the disease should remain unavailable on the NHS because they did not meet NICE criteria for "cost-effectiveness".

 

The drugs cost between £20,000 to £35,000 a year per patient and although they cannot "cure" advanced renal cell carcinoma or cancer that has spread from the initial tumour they can help extend a patients' life by around five to six months.

 

Sir Michael told the Observer other patients would have lost out: "We have a finite amount of money for healthcare, and if you spend money one way your can't spend it another."

 

http://news.bbc.co.uk/1/hi/health/7566253.stm

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Fop why do you always posts articles like this and then not actually give your own opinion on the above?

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Fop why do you always posts articles like this and then not actually give your own opinion on the above?

 

Why does Happy Face, Fish and Dr Ken do the same?

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Fop why do you always posts articles like this and then not actually give your own opinion on the above?

 

Why does Happy Face, Fish and Dr Ken do the same?

I don't know as I wasn't asking them that specific question. Next time I'll find out though.

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Fop why do you always posts articles like this and then not actually give your own opinion on the above?

 

Why does Happy Face, Fish and Dr Ken do the same?

I don't know as I wasn't asking them that specific question. Next time I'll find out though.

Probably to avoid this - is the answer.

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Google has revenues of $16bn and makes a profit of $4bn, which is a larger ratio than a drug's company. Typically, with a revenue of around $40 bn (Roche, Novartis, Pfizer, GSK), they can expect to make $6-9bn in profit. Marketing costs also include the salaries of the 50,000 people they employ in marketing related activities. Thats a benefit to the UK he hasnt even looked at. It also supports the salaries of the other 50,000 involved in R&D and Manufacturing

 

Google are more profitable because of their business model. However, the rate of return to their shareholders cant be a problem as their motto is 'Dont be evil'.

 

Rawlins may well be correct but we'd have to drop the price by 70% to get it approved in the UK. That would eradicate all profits if implemented across the board. I agree that some of the new cancer drugs are too expensive and as an economist working on the inside, i spend a lot of my time arguing for lower prices to gain better access to markets (watch this space on kidney cancer).

 

One of the other things Rawlins has no experience of is corporate finance and investment. No investor in the world backs a risky business for an average return. The higher the risk, the higher the return required.

 

I'm not going to argue about this as it all boils down to one philosophical question; are healthcare and profit incompatible? If you include health in Amartya Sen's 'capability set' (google it), then you can argue that they arent compatible and that healthcare is a fundamental right of man. There are parts of me that are sympathetic to that view. However, as a trained economist, i would point to the lack of an incentive to invent new drugs in the first place.

 

Its facile and idiotic to say that medicines dont bring huge value to a society too fop (just anticipating your typical view).

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The drug companies are businesses - they exist to make a profit

 

Stupid to criticise them - its the hope of a big payout that drives them to develope new drugs. Without them we'd be dependent purely on the Govt (gulp!) and academia and they don't have a clue how to produce and distribute things

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However, as a trained economist, i would point to the lack of an incentive to invent new drugs in the first place.

 

You said that wasn't the case when I pointed it out. :shades:

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A lot of new drugs are crap though aren't they?

Better back in the day iyam.

 

 

Leeches were good enough in me mam's day and they should be good enough for you

 

and anasthetic is for whimps

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A lot of new drugs are crap though aren't they?

Better back in the day iyam.

 

 

Leeches were good enough in me mam's day and they should be good enough for you

 

and anasthetic is for whimps

 

There is literally nothing a wee dram with an egg in it can't cure. FACT.

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Guest alex
A lot of new drugs are crap though aren't they?

Better back in the day iyam.

 

 

Leeches were good enough in me mam's day and they should be good enough for you

 

Take a bit drying out though.

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http://news.bbc.co.uk/1/hi/health/7579530.stm

 

 

Experts in drug 'ration' warning

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NICE advises on which drugs should be bought by the NHS

 

Some of the UK's top cancer consultants warn that NHS drug "rationing" is forcing patients to remortgage their homes to pay for treatment.

 

The specialists accuse the government drugs advisory body of "rationing" too severely and call for a "radical change" in the way decisions are made.

 

Their letter to the Sunday Times also says research success is not being translated into modern treatments.

 

It follows a decision not to offer some drugs to NHS kidney cancer patients.

 

Earlier this month, the National Institute of Health and Clinical Excellence (NICE) published its draft guidelines on treatments for patients with advanced kidney cancer.

 

 

 

We have seen distraught patients remortgaging their houses, giving up pensions and selling cars to buy drugs

Letter signed by 26 consultants

 

It concluded that the drugs - bevacizumab, sorafenib, sunitinib and temsirolimus - did not offer value for money.

 

But in their letter, the 26 cancer specialists say the decision shows how "poorly" NICE assesses new cancer treatments.

 

"Its economic formulas are simply not suitable for addressing cost-effectiveness in this area of medicine," they write.

 

Professor Jonathan Waxman on the cancer drug row

 

They continue: "It is essential that NICE gets its sums right. We have seen distraught patients remortgaging their houses, giving up pensions and selling cars to buy drugs that are freely available to those using health services in countries of comparable wealth."

 

The consultants, who include the directors of oncology at Britain's two biggest cancer hospitals, the Royal Marsden in London and Christie Hospital in Manchester, say it is not right the NHS cannot find the money for the drugs.

 

"We now spend similar amounts to Europe on health generally and cancer care in particular, but less than two thirds of the European average on cancer drugs.

 

"It just can't be that everybody else around the world is wrong about access to innovative cancer care and the NHS right in rationing it so severely."

 

 

 

There is a finite pot of money for the NHS, which is determined annually by parliament

National Institute of Health and Clinical Excellence

 

While Britain is a leading contributor to cancer research, this is not translated into "modern treatment for all our patients," they say.

 

They add: "The time has come for a radical change in how the NHS makes rationing decisions for cancer."

 

Professor Peter Johnson, from Cancer Research UK, earlier this month also said NICE's decision raised "questions" about whether its system of appraisal was appropriate for all types of drugs.

 

Andrew Dillon, the NICE chief executive, and Sir Michael Rawlins, NICE's chairman, told the Sunday Times the NHS did not have unlimited funds to provide all available treatments.

 

"There is a finite pot of money for the NHS, which is determined annually by parliament," they said.

 

"If one group of patients is provided with cost-ineffective care, other groups - lacking powerful lobbyists - will be denied cost-effective care for miserable conditions like schizophrenia, Crohn's disease or cystic fibrosis."

 

Waste

 

Dr Evan Harris, a Liberal Democrat MP and former hospital doctor, said rationing was inevitable unless the government increased funding or came up with a fairer way to measure what was cost-effective.

 

"Attacking NICE is simply shooting the messenger and letting politicians off the hook.

 

"The government must let NICE get its teeth into vetoing the millions of pounds the NHS spends on wasteful political initiatives - like over-paying private firms to cream off routine NHS cases - and on totally ineffective treatments, like homeopathy.

 

"That could save the money needed for effective but expensive cancer drugs."

 

The Department of Health said investment in the NHS had risen from £35bn in 1997 to more than £110bn by 2011.

 

A spokeswoman said: "We have heard from patients that one of their major concerns is the perceived postcode lottery in access to drugs and that there are too many variations around who gets access to prescribed drugs and that these variations are a lottery depending on where you live.

 

"The draft NHS constitution will make more transparent and consistent the process for local funding of drugs not appraised by NICE or where NICE has yet to issue guidance."

 

More than 7,000 people are diagnosed with kidney cancer annually in the UK.

 

Of these, around 1,700 patients will be diagnosed with advanced kidney cancer.

 

Although none of the available treatments "cure" cancer that has spread from the initial tumour, they can help extend a patients' life by around five to six months.

 

http://news.bbc.co.uk/1/hi/health/7579422.stm

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Interesting insight into NICE, drug companies, cost and what is best for a patient.

 

 

 

 

Lucentis: An NHS dilemma

By Nick Triggle

Health reporter, BBC News

 

Lab

The availability of drugs in the NHS is a complex issue

The phrase postcode lottery has become a cliche when talking about the NHS.

 

Outraged campaigners can be found filling newspaper column inches and TV and radio airtime criticising the availability of drugs in one area and not another.

 

But buried beneath the headlines is a much more complex picture - and no where is that more apparent than in the case of the sight-saving drug Lucentis.

 

The injections are indeed a modern wonder. Few drugs that come on to the market these days can boast they effectively cure a condition.

 

But that is just what a two-year course of the drug does for people suffering from wet age-related macular degeneration, the leading cause of blindness in the UK.

 

However, the treatment comes at a price - £10,000 for each eye to be precise.

 

The cost initially prompted the National Institute for Health and Clinical Excellence, the body which assesses drugs for the NHS, to say it should only be used when someone has gone blind in one eye.

 

Outrage

 

This, of course, provoked outrage and NICE eventually relented.

 

But perversely that decision now means a treatment that a significant number of doctors had been using to fight the condition at a fraction of the cost of Lucentis may have to be dropped.

 

This is despite eye specialists which are using Avastin, more commonly known as a bowel cancer drug, believing it can be as effective at treating AMD as Lucentis.

 

With NICE approving Lucentis, health bosses may feel duty bound to tell doctors they can only use the more expensive drug.

 

It is an issue which has exercised Derbyshire Primary Care Trust in particular.

 

The trust is responsible for funding local services and as such is concerned about the finances.

 

It told NICE ahead of its decision on Tuesday that it should give consideration to Avastin as it could save the health service money.

 

It pointed out that it is being used in such a way in Italy and the US as well as by eye specialists in the UK in their private practice.

 

 

As a tax-payer, I want to know why the NHS is going to spend 30 to 50 times as much on a drug when there is a cheaper alternative

Michael Lavin, eye surgeon

 

But the problem is that NICE cannot recommend Avastin for wet AMD treatment because it can only consider drugs for their licensed purpose.

 

And the company which developed Avastin, US firm Genentech, also produced Lucentis.

 

Suffice to say, it is not in Genentech's interests to spend money on getting a licence for Avastin to treat wet AMD.

 

Roche, the drug firm which is marketing Avastin in Europe for Genentech, says neither firm is planning to push forward for a licence for wet AMD.

 

A spokeswoman said 10 years were spent developing Lucentis for the market and it was best to focus on Avastin's use in the battle against cancer.

 

"Avastin has brought clinically meaningful benefits in three major cancers, and Roche therefore remains committed to its further development in the treatment of cancer."

 

Nor has a strong campaign been forthcoming from campaigners such as the Royal National Institute for the Blind (RNIB).

 

The RNIB, like many charities, are partly reliant on drug firms for donations. One of their donors is Novartis, the firm responsible for marketing Lucentis for Genentech in the UK.

 

No-one is suggesting RNIB has been influenced - and indeed the charity points out Novartis' donation is responsible for less than 0.3% of its income and trials have yet to prove the effectiveness of Avastin - but the relationship demonstrates that there is much more to the story than the headlines suggest.

 

Relationship

 

NICE chairman Sir Michael Rawlins is already on record questioning the relationship between patient groups and drug firms.

 

In particular, he has suggested they should do more to quiz firms about the cost of drugs.

 

Patient groups have not been shy to have their say, claiming it takes too long for NICE to recommend treatment.

 

Lucentis alone took two years to work its way through the system - and in the meantime NICE was not even able to recommend a cheaper alternative.

 

And in the end it illustrates the dilemma the NHS faces.

 

Michael Lavin, an eye surgeon from Manchester Royal Eye Hospital, has been using Avastin to treat wet AMD since 2005.

 

He says as a doctor he is happy to use either, describing their effectiveness as "probably equivalent".

 

But he adds: "As a tax-payer, I want to know why the NHS is going to spend 30 to 50 times as much on a drug when there is a cheaper alternative."

 

Unfortunately, there is not a simple answer.

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http://www.telegraph.co.uk/opinion/main.jh...8/27/dl2701.xml

 

"Insurance companies are waiting to offer low-cost policies to top-up basic NHS care. That will leave Nice facing fewer life-and-death decisions because patients will be able to buy their own life-saving treatments without jeopardy."

 

As announced on here about 2 months ago.

 

I like to keep you abreast of developments ahead of time. :)

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But the problem is that NICE cannot recommend Avastin for wet AMD treatment because it can only consider drugs for their licensed purpose.

 

And the company which developed Avastin, US firm Genentech, also produced Lucentis.

 

Suffice to say, it is not in Genentech's interests to spend money on getting a licence for Avastin to treat wet AMD.

 

More this bit.

 

 

 

 

 

 

 

 

 

Although I've had two members of my extended family die of cancer this week, both would have lived at least 6 months longer with private heathcare.

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I presume you need to split up doses of Avastin for eye treatment as the doses used for cancer are massive.

 

http://www.mdsupport.org/library/avastin.html

 

Sorry to hear about your loss, they would have probably lived 6 months longer if they were german or french too.

 

 

Probably, but that's not really the issue, the issue is it won't be able to be used because there is no profit in it (or not as much as two separate options).

 

Undoubtedly, both spend a lot more per capita on cancer than the UK.

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