It is self evident that we cannot afford everything. In health we only find this out when we need a non-funded treatment, such as Orkambi. There are other examples, such as Yescarta, Anticoagulant monitors etc. With drugs the perverse incentive is for authorities to decline them for as long as possible, so that they get as near to their patent expiry (12 years) as possible. Usually media pressure brings the state funding forward by a few years.. But in the intervening period the “health divide” means that only those who can afford it will get the new treatments. We could afford all these treatments once they were proven, if we agreed to ration out high volume low cost treatments. Indeed, for a disease like CF, the advent of CRISPR could ensure that fewer and fewer people need the drugs. This is the longer term solution, but shorter term our politicians need to ration honestly and overtly, large volume low cost products, so that those unfortunate enough to have an expensive disease can be treated. Even America is not covering Orkambi…
Kimberly Roberts is the mum of three-year-old Ivy, who has cystic fibrosis – or CF – which is a genetic lung disease with no cure.
Along with her friend Alison Fare, who has two daughters with the condition, they want access to one of the most advanced treatments – the drug Orkambi.
But the manufacturer and NHS bosses have been locked in arguments over its £100,000-a-year price tag since 2015.
“Our children deserve to have it – deserve to live a healthy long life. Without that drug they won’t have one,” said Mrs Roberts, who lives near Conwy in north Wales.
Nice – the body which recommends whether a drug or treatment is available on the NHS – has said that the ongoing bills for the drug would be “considerably higher than what is normally considered a cost-effective use of NHS resources“….
…Nice has said the cost for the drug would be “considerably higher than what is normally considered a cost-effective use of NHS resources“.
In July, NHS England made an offer of £500m for five years to have the treatment, with £1bn over 10 years.
But while that offer remains on the table – the deal has not been done.
Kate Thomas for the NY Times 24th June 2018: A Drug Costs $272,000 a Year. Not So Fast, Says New York State. – New York’s Medicaid program says Orkambi, a new drug to treat cystic fibrosis, is not worth the price. The case is being closely watched around the country.
In PharmaTimes, Selina McKee, online 9th July 2018: Vertex, NHS England no closer to Orkambi settlement