Scottish first minister urges Roche to reduce Perjeta price for NHS access

LONDON, 11 May (APM) - Roche needs to consider lowering the cost of breast cancer drug Perjeta (pertuzumab) for it to be made available in Scotland, the country’s first minister Nicola Sturgeon has said.
Scottish Conservative leader Ruth Davidson on Thursday questioned Sturgeon on the lack of access to the drug in Scotland despite it being available in England and Wales to treat women with HER2- positive metastatic breast cancer in combination with Roche's Herceptin (trastuzumab) and docetaxel.
The drug has been turned down three times by the Scottish Medicines Consortium (SMC), most recently in June last year, with the health technology assessment (HTA) body determining that the price of the drug is too high despite offering benefits to patients (APMHE 53469).
England’s NICE initially turned down the drug in 2013, but the drug was then made available in the country via the Cancer Drugs Fund (CDF), which in its then form was a fund to cover cancer drugs not recommended by the HTA body (APMHE 35130).
Following reforms to the CDF, NICE, NHS England and Roche entered new negotiations on the drug, leading to a confidential commercial agreement in November 2017, paving the way for routine access (APMHE 55543 and APMHE 56696).
During first minister’s questions Davidson challenged the different circumstances for Perjeta in Scotland and England.
“The fact is if women in Scotland lived just a few miles south of the border they wouldn’t have to think about moving house or uprooting their family to have access to a medicine that keeps them alive.”
She also pressured Sturgeon to make a deal similar to the one agreed between Roche and the NHS in England.
Sturgeon responded that she hoped that the NHS in Scotland would come to an access agreement with Roche, but that the Swiss firm needed to price the drug accordingly.
“There is a process underway about Perjeta. I hope that process concludes positively as quickly as possible but part of the responsibility there is for the drug company to come forward with a fair and transparent price for the drug. And I hope one thing we can agree on today is to encourage the dug company to do exactly that.”
Sturgeon also suggested there have been reverse situations where a cancer drug is available in Scotland but not in England. She did not mention any products by name, but recent situations where this has been the case include Roche's Gazyvaro (obinutuzumab) for follicular lymphoma (APMHE 52210).
The first minister, who also the leader of the Scottish National Party (SNP), also defended her government’s policies on drug access, saying that changes made between 2014 and 2016 mean that the SMC now approves 75% of drugs for ultra orphan, orphan and end of life indications. This compares with 48% for the 2011 to 2013 period.
The Scottish government committed to further reforms at the end of 2016 with the publication of the Montgomery report (APMHE 50901), but Davidson criticised the lack of action on these recommendations over the past 17 months.
Sturgeon responded: “There is further work being led by NHS National Services Scotland right now. And it is important that we continue to reform a system. As I’m sure will be the case in other parts of the UK to make sure it operates as well as it possibly can.”
She also reinforced the important of having an independent body like the SMC to make decisions on drug access in Scotland.
“But I think this is the important point. No matter how good and efficient the system is, that doesn’t remove the need for independent decisions to be taken on individual drugs.”



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