[Ip-health] SPICY IP: Roche vs CIPLA: UK Rejects Tarceva as Too Expensive!!

[James Love]

http://spicyipindia.blogspot.com/2008/04/roche-vs-cipla-uk-rejects-tarceva-=
as.html

Date: Wed, 30 Apr 2008 07:27:30 -0700 (PDT)

SPICY IP: Roche vs CIPLA: UK Rejects Tarceva as Too Expensive!!

Jason Douglas of  Dow Jones reports
<http://www.lloyds.com/CmsPhoenix/DowJonesArticle.aspx?id=3D389002>  that:

" The U.K's National Institute for Health and Clinical Excellence said
Thursday that Roche Holding AG's (RHHBY) drug Tarceva has been turned
down as a treatment for non-small cell lung cancer because it's too
expensive.

NICE said Tarceva could not be considered a cost-effective use of the
U.K.'s state-run National Health Service's resources compared to
Sanofi-Aventis's (SNY) Taxotere.

NICE, which determines whether drugs should be available on the NHS in
England and Wales on the basis of their effectiveness and value for
money, said the cost of Tarceva was considerably higher than acceptable.
It found Tarceva was GBP 2,100 more expensive to buy per patient than
Taxotere and said it was not persuaded that Roche had proved its drug,
known generically as erlotinib, had an equivalent survival benefit to
Taxotere, or docetaxel.

Professor Peter Littlejohns, Clinical and Public Health Director, said
NICE has yet to make a final decision on Tarceva and won't issue final
guidance to the NHS until June.

Tarceva is licensed in Europe for the treatment of patients with
advanced or metastatic non-small cell lung cancer, for whom other drugs
have failed."

So let's get this straight. It's not just a "crazy" patent busting
country like India that has issues with the price of Tarceva--it turns
out that a richer and more patent friendly nation like the UK has a
problem as well! And we might add that the UK boasts of a nationwide
health insurance scheme. For our previous posts on the Roche vs CIPLA
patent litigation in India, please see here
<http://spicyipindia.blogspot.com/search/label/Roche%20vs%20Cipla> .

I am now trying to investigate the price of Tarceva in the US and UK, so
that we can compare with the price in India. If anyone has data on this
or pointers in this, please write to me at <shamnad@gmail.com>. If you
permit me, I will also share this information with all our readers on
the blog.

Thus far, I have found only one cancercommunity group
<http://www.cancercompass.com/message-board/message/single,7857,1.htm>
 and a NY Times article
<http://www.nytimes.com/2005/07/12/business/12cancer.html>  that seems
to suggest that the price of Tarceva in the US is the same (or even
slightly higher) than the price in India! I reproduce the message below:

"How are all of you affording the cost of Tarceva?
My mother was just prescribed Tarceva. She is 89 years old and on a
limited income. After the insurance pays 1/3 the cost of Tarceva, she
will have to pay $2,400.00 out of pocket for a 30 day supply. She can't
afford this."

>From the above message, it is clear that the total monthly cost of this
drug in the US is USD 3600 (or 1.44 lakhs Indian Rupees). Justice Bhat
in his judgment found that the monthly cost in India was Rs 1.4 lakhs.
In other words, the cost of the drug in India may be slightly more
expensive than in the US!

Of course, what is quoted here is a 2006 price--which may have changed
since then. However, it is unlikely that the change would have been
significant.

It is notewothy that a NY times article
<http://www.nytimes.com/2005/07/12/business/12cancer.html>  pegs the
price of Tarceva in the US at 2700 a month. Which means that the price
is higher in India  (USD 3600) than it is in the US!

See also this Forbes article
<http://www.forbes.com/2004/06/08/cx_mh_0608costs.html>  in 2004, and
this BBC article
<http://news.bbc.co.uk/2/hi/uk_news/england/kent/4695110.stm>  in 2006
which lamented the increasingly high costs of cancer drugs, including
Tarceva.

Interestingly, the cancercommunity group
<http://www.cancercompass.com/message-board/message/single,7857,1.htm>
 that I mentioned earlier has a message from someone in India:

"hello, my mom was diagnoised with lung cancer 6 months back. She has
finished 5 cycles of chemo treatment consisting of Carboplatin/gemcite.
 We are unable to give further chemo treatments becasue of her low blood
counts. Under this conditions, i am exloring the usage of Terceva for
her. But it seems to be very costly. We are uanable to afford for such
high cost for treatment. Moreover in India , we dont have insurance
which cover diseases like this .

I would be glad if you could guide me , as to how to procure Terceva
from some cherity or any type of NGO or any type of social
instituation .  Hoping to hear from you.

Rajiv"

Recall our earlier post
<http://spicyipindia.blogspot.com/2008/04/roche-vs-cipla-rhetoric-of-patent=
.html> , where we attempted to debunk the use of terms such as "patent bust=
ing" to describe Justice Bhat's nuanced judgment. The above prices in the W=
estern and more "developed" markets indicate that Justice Bhat was right to=
 be concerned about the price and to build in this "public interest" factor=
 into the injunction jurisprudence in India.

The question we ask our readers is this:

>From a policy perspective, isn't it only fair that a country like India
be given the freedom to derogate from a patentee's exclusive rights,
when the patentee's price in India (a much poorer country with no
universal health insurance coverage) is the same that it charges in the
US? Particularly, when the validity of the patent is in issue?

On another note, why don't innovative pharmaceutical companies  take
more meaningful steps towards a differential pricing model? What stands
in the way? Threat of parallel imports? The fear that lower prices in
India would cause their own home consumers to begin demanding lower
prices back home? See our previous posts on the parallel imports issue
here
<http://spicyipindia.blogspot.com/2008/03/foreign-pharma-may-adopt-differen=
tial.html>  and here <http://spicyipindia.blogspot.com/2007/12/technology-s=
olution-for-parallel_09.html> .