Today, the secondary breast cancer drug Perjeta was rejected for routine use on the NHS in Scotland. James Jopling, Breakthrough’s Director for Scotland, explains why it’s high time we addressed the challenges that high-price medicines present.

Whilst my disappointment about pertuzumab (Perjeta) being rejected for use by the NHS in Scotland won’t change the decision, it’s something I feel deeply.  I didn’t want to spend any of my day today trying to explain why an incredibly effective drug for women with a particular type of secondary breast cancer isn’t going to be widely available.

Because in so many ways it doesn’t make sense. 

No one wants a new, effective treatment left on the shelf. Not pharmaceutical companies who spend hundreds of millions of pounds developing drugs. Nor medical professionals who’ve seen the impact of drugs like Perjeta through clinical trials and now face having to tell patients they can’t benefit in the same way.  And certainly not patients, who have lost a new tool in their armoury to protect them from the advances of the terminal disease.

Huge improvements

Perjeta is specifically for people who have a type of breast cancer which is called HER2-positive. It’s given to patients whose cancer has either returned in the breast after previous treatment or has spread to another part of the body. It works together with another drug, Herceptin, to slow down cancer growth, and is given together with chemotherapy. It has been shown to work better than alternative treatments, with few additional side effects. This means that patients have more precious quality time with their families and loved ones.

In trials, Perjeta has been shown to increase the time before breast cancer progresses by six months compared to the usual treatment, from 12 months to 18 months. This means that patients have an extra six months of good quality life before their cancer continues to grow. Perjeta has also been shown to improve the length of time that patients live – by 16 months, which is a huge improvement for patients with secondary breast cancer. Importantly, these improvements were seen without any significant additional side effects compared to the existing treatment.

But with a cost of a course of treatment coming in around £100,000, no one is pretending that rejecting Perjeta was an easy decision for the Scottish Medicines Consortium (SMC) to have taken.

Further disappointments

What is particularly disappointing is that Roche, the manufacturers of this drug didn’t submit a ‘Patient Access Scheme’ – a way of offering the Government the drug at a reduced cost. This could have made all the difference in getting the drug approved.  But for reasons you’d need to ask them, this wasn’t done on this occasion.  It’s more surprising when you consider that the price this was submitted at was three or four times the level that drugs had previously been approved at in Scotland.  So without any reduction in price and a previous submission of this drug in the last year, the chances of approval were incredibly slim.

The fact is that the hundreds of women who could have had their quality and quantity of life extended in Scotland now won’t routinely get access to this medicine.

There must be a better way to address the challenges that high price medicines such as these present to the NHS.  We must demand a fairer price. As drug pricing is the responsibility of the UK Government, you can help by writing to your MP today – act now to send your letter asking politicians to fix the broken system.

James Jopling is Breakthrough's Director for Scotland