[Ip-health] Guardian Unlimited: NHS doctors challenge high drugs prices

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Guardian Unlimited: NHS doctors challenge high drugs prices
To see this story with its related links on the Guardian Unlimited
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NHS doctors challenge high drugs prices
Sarah Boseley, health editor
Monday July 30 2007
The Guardian


British doctors are to rebel against high prices set by
pharmaceutical companies for their products by giving patients a
cheap but unlicensed drug that prevents blindness, the Guardian has
learned.

Unable to afford to treat all those losing their sight with a
licensed and extremely expensive drug, Lucentis, some primary care
trusts are giving NHS doctors the green light to use tiny shots of a
similar drug, Avastin, which is marketed for bowel cancer, but costs
a fraction of the price. Avastin is widely used for eye complaints in
the United States.

A call from the former health secretary, Patricia Hewitt, for
Avastin's manufacturer to put the drug through trials for wet age-
related macular degeneration went unheeded. Now the NHS is funding a
groundbreaking trial which will compare Avastin directly with
Lucentis. Both drugs are manufactured by Genentech.

The moves represent the first real challenge in this country to high
prices set by drug companies. There is growing unease at the cost of
new drugs and high prices have led to the banning or rationing of
some medicines in the NHS by the National Institute for Health and
Clinical Excellence (Nice). The companies say they need billions of
dollars in sales to recoup their research and development costs, but
critics accuse them of profiteering.

Meanwhile, in the developing world, unaffordably high drug prices
have brought the pharmaceutical industry into disrepute, forced their
prices down and led to successful campaigns to allow generic copycat
companies to sell cheap versions of drugs.

Around 26,000 people develop wet age-related macular degeneration
(AMD) every year - a condition that can make them blind within
months. Lucentis can save and even improve their vision - but
Genentech, the manufacturers, and Novartis, who market it in the UK,
have set the price so high - at £761.20 per injection - that
Nice has said it should only be used in the 20% worst cases and then
only when patients have already lost the sight of one eye.

Appalled at the implications, a number of ophthalmic surgeons in the
UK are now offering treatment with Avastin, a very similar but bigger
molecule also made by Genentech but licensed for bowel cancer. One
bowel cancer phial can be split into many tiny doses suitable for
injection into the eyes, costing as little as £10 a shot. In
spite of the absence of trials or a licence, the use of Avastin has
spread through the US and there is now data on more than 7,000
patients. It has also been used by some private clinics in the UK.

In the Greater Manchester area, public health directors of PCTs have
taken the unprecedented decision to offer patients Avastin on the
NHS. "We think as many people as possible should be treated for wet
AMD. To afford it we need to use Avastin," said Peter Elton, director
of public health for Bury, who is leading on the issue for the
Greater Manchester area. "If you have only got one eye affected, the
other eye might get something else the next year. By the time you
come to treat the wet eye, it has gone too far. We think that is not
ethically acceptable."

He and his colleagues are happy with the evidence amassed so far and
he points out that Medicare, the state-funded healthcare service in
the US, is using Avastin in 48 out of 50 states.

Moorfields eye hospital in London, the most famous in the country, is
also exploring a scheme to use Avastin on the NHS. But the stakes are
so high for the NHS that it is taking the unprecedented step of
funding a trial which will directly compare the use of Avastin and
Lucentis in wet AMD.

Copyright Guardian News and Media Limited



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