combination for treating skin cancer approved for NHS use – but can we afford it without rationing?

Since 2010 specialists around the country have known about these new drugs. Different Health Commissioners have had different attitudes to provision, but now there is a lever playing field, (Rise in admissions of Welsh cancer patients treated in England ) hopefully without reference to age. Can we afford it without rationing? The pace of technological advance exceeds our ability to pay.  The cost of nivolumab (Opdivo) in UKMi New Drugs Online Database. Sep 14: Bristol-Myers and marketing partner Ono Pharmaceutical launch Opdivo in Japan for unresectable melanoma at an annual cost of $143,000 per patient. Analysts expect an annual cost of at least $110,000 in the US [8].  Bristol-Myers Squibb is pricing ipilimumab at $30,000 per injection. This translates to a cost of $120,000 for a course of therapy, based on the approved dosing regimen of 3 mg/kg every 3 weeks for four doses. The company’s patient-assistance program, however, may reduce net pricing to $80,000.  At $263,000 or £180,000 per patient and with 15 per 100,000 population my back of an envelope calculation totals 10,500 persons per annum, and costs £1800m. Obviously costs will be reduced by volume, but it’s still an enormous figure. We can affords it, but only if we ration honestly at the cheap end of high volume services.

Sarah Boseley reports in The Guardian 17th June 2016: Drug combination for treating skin cancer approved for NHS use – Medicines regulator Nice moves at record speed to approve nivolumab for use with ipilimumab in melanoma patients and the Times points out that England and Wales will be the first European countries to approve the new therapy.

Skin cancer patients in England and Wales will become the first in Europe to benefit from a powerful combination of drugs.

The National Institute for Health and Care Excellence (Nice) has approved the combination therapy of Opdivo (nivolumab) and Yervoy (ipilimumab) for people with melanoma that has spread around the body.

The drugs can stall progression of advanced melanoma by an average of eight months compared with standard treatment and have been found to wipe out tumours in about a fifth of patients.

Some 1,300 people could be eligible for the immunotherapy drugs every year, in one of the fastest drug appraisals carried out by Nice.

People with advanced skin cancer live less than two years on average. Melanoma accounts for about 1,750 deaths in England every year. A total of 12,200 people were diagnosed with the disease in 2013.

Carole Longson, of the Nice health technology evaluation centre, said: “These treatments for advanced melanoma look set to significantly extend the life of people with the condition.”

Immunotherapy drugs enable the body’s immune system to fight tumours and have shown promising results on other cancers, including lung cancer.

Health technology advancements were outstripping our ability to pay for them – we need to ration overtly

Increasing hopeful drugs and diagnostics for Malignant Melanoma. Will these be available to you?

The threat of Malignant Melanoma: it may expose the Post Code Lottery at it’s worst

Skin cancer trial results ‘exciting’ but there is no equality in access to cancer treatments.

Skin Cancer doubles in 20 years

Good News: Gene Therapy and its potential impact on us all


This entry was posted in Good News, Rationing, Stories in the Media on by .

About Roger Burns - retired GP

I am a retired GP and medical educator. I have supported patient participation throughout my career, and my practice, St Thomas; Surgery, has had a longstanding and active Patient Participation Group (PPG). I support the idea of Community Health Councils, although I feel they should be funded at arms length from government. I have taught GP trainees for 30 years, and been a Programme Director for GP training in Pembrokeshire 20 years. I served on the Pembrokeshire LHG and LHB for a total of 10 years. I completed an MBA in 1996, and I along with most others, never had an exit interview from any job in the NHS! I completed an MBA in 1996, and was a runner up for the Adam Smith prize for economy and efficiency in government in that year. This was owing to a suggestion (St Thomas' Mutual) that practices had incentives for saving by being allowed to buy rationed out services in the following year.

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