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Industry in final hour discount negotiations with NHS England for cancer drugs

by Richard Staines and Helen Collis
LONDON, Jan 8 (APM) - Cancer drug makers have one day to negotiate price discounts with NHS England for products rejected by NICE to continue to be covered by the Cancer Drugs Fund, according to a source.
A total of 44 drugs, including Eisai’s Halaven (eribulin) and Roche’s Perjeta (pertuzumab) for breast cancer, are being assessed by NHS England for both their clinical and cost effectiveness.
They will be scored on each assessment and must receive a total score above a threshold to maintain funding by the Cancer Drugs Fund. If a drug fails the clinical assessment, the drug will not be funded, the source said.
If they pass the clinical assessment, but the score for the cost-effectiveness assessment is not within the threshold, companies can improve their total score by offering price discounts, the source added.
“The score is subject to flex depending on whether a company is going to give a discount,” the source said, adding that “there is nothing they can do if it’s (the drug) is clinically ineffective”.
NHS England is due to publish the list of drugs it will continue to fund on Monday and companies are negotiating with the decision-making body “every day” to find a solution. The source said the situation was “changing continuously … every day” regarding progress in the negotiations.
Not all drugs will need discounts to remain on the list, the source said. Those which achieve the required total score from the two assessments will automatically be reprieved.
Press reports on Thursday said among those in discussions to remain on the list were Eisai's Halaven (eribulin), Roche’s Avastin (bevacizumab), Kadcyla (trastuzumab emtansine) and Perjeta (pertuzumab), Novartis’ Afinitor (everolimus) and GlaxoSmithKline’s Tyverb (lapatinib).
APM contacted several companies for comment on Thursday but was told discussions were confidential and details could not be shared. The final list is due for publication by NHS England on Monday morning, they said.

NHS England says confidential discussions ongoing

In a brief telephone conversation with APM, a spokeswoman for NHS England said confidential discussions with manufacturers are ongoing.
The panel that runs the Cancer Drugs Fund (CDF) will make final decisions on which drugs are available next week.
In an emailed statement, professor Peter Clark, chair of the CDF and practising oncologist, said: “We need to get maximum value for every pound we spend through the CDF. We can no longer sustain a position where we are funding drugs that don’t offer sufficient clinical benefit when drugs that will do more for patients are coming on stream.”
NHS England added that the CDF is on course to spend 380 million pounds (486 million euros) by the end of the financial year - 100 million pounds (128 million euros) over budget.
As a result, NHS England said it must prioritise the drugs that offer the best value. In December 2014, the panel, comprising doctors, pharmacists and patients representatives reviewed all available evidence for 56 drug indications.
Of these, 44 drugs are available on the fund and 12 were new applications.
An NHS England spokeswoman said: “Decisions will be made early next week. Confidential discussions are ongoing.”
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