Drugmakers are accustomed to grappling with government payers and PBMs over prices. They're used to getting the stiff arm from cost-effectiveness watchdogs like those at the U.K.'s National Institute for Health and Care Excellence (NICE). They're even used to the critics at patient-access organizations.
But a pricing fight directly with patients? That's not your everyday occurrence.
A U.K. cancer survivor has gathered almost 30,000 signatures on a petition asking Roche ($RHHBY) to lower the price of its new breast cancer treatment Kadcyla. The breakthrough armed-antibody therapy is priced at about $94,000 for a 9-month course--or almost $150,000 when used as designed, alongside Roche's other new breast cancer drug, Perjeta.
The online petition's signatories are from all over the world, and some include comments alongside their signatures. A few are coolly rational--drug prices need to cover the cost plus a reasonable markup, one said--but others are emotional tirades. Not the sort of conversation drugmakers want to hear about themselves and their products online.
It's another sign that the fight over drug prices is spilling over from payers to the public, upturning the usual dynamic of cost-conscious payer on one side, and patients and drugmakers on the other. When NICE first rejected Kadcyla in April, patient groups joined Roche in complaining about the decision. In August, with NICE's final "No," those groups attacked the agency, unimpressed by CEO Andrew Dillon's cost-effectiveness reasoning. A Roche manager called NICE's decision "an incredible injustice" and an indicator that the system of evaluating drugs is "in need of a complete overhaul" in breast cancer.
|NICE CEO Andrew Dillon|
But something funny happened after that. Dillon struck back, saying that patients and drugmakers upset about cancer drug rejections needed to point the finger at the companies and not at the agency. And at least one breast cancer group called not only on NICE to change its mind, but also on the industry to work with the agency to bring down the cost of their drugs.
And now, the call for lower prices has gone public. Launched by cancer survivor and U.K. resident Margaret Connolly, the petition tries to tug on the heartstrings, by highlighting not her own experience but that of her niece, who died of the disease more than a decade ago. "It traumatised her, the thought of leaving her wee boy as he was so young," Connolly says in a press release about the petition.
Roche has said repeatedly that Kadcyla's price is an expression of its value to patients. Even NICE admits that it can extend the lives of women with advanced disease by 6 months on average. Its companion treatment Perjeta just aced a long-term trial by helping women live almost 17 months longer, when given at earlier stages of the disease.
The plea to Roche is similar to the petitions asking companies to give dying patients access to drugs that haven't been approved yet by the FDA. It's a grassroots effort that appeals to the emotions--and gets people emotional, as the hundreds of comments on Connolly's petition show. It's on the Care2.com website, where other petitions have taken hold. And it's an argument that seems simple to the people who sign the petition, which means the complex answers drugmakers have to offer will inevitably fall flat.
Brace yourself for more, too. Similar petitions--about one drug or another--are sure to pop up online. It's almost as if these patients and potential patients are taking Dillon's advice.
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