Better cancer drugs will cost NHS dear, warns professor

Professor David Cameron, an expert in breast cancer from Edinburgh University, said new treatments were increasingly being developed which targeted specific subtypes of cancer, helping make them more effective.

However, he said because these treatments were used to treat smaller groups of patients they would be more expensive, increasing costs for the NHS but also improving patient care.

The warning comes as the NHS already faces pressure to fund a growing number of costly cancer drugs. In some cases, the high costs compared to their effectiveness mean drugs are not recommended for use on the NHS.

Next week, a public talk in Edinburgh will hear about the latest advances in targeting the right treatments to patients with ovarian and breast cancer.

This involved using knowledge of genetics and other factors to tailor drugs for particular subtypes of cancer – referred to as “stratified” treatments.

Such approaches have already been seen with particular hormone treatments for breast cancer, as well as Herceptin which is used in patients whose cancer has a protein known as HER2.

Research in Edinburgh has also discovered how to subtype different types of ovarian cancer.

Prof Cameron said treatments were now being developed to target particular types of lung, skin and colorectal cancer.

He said part of the reason for the higher cost of these drugs was the need for further tests to determine the type of cancer a patient had, as well as a bigger bill from drugs companies as the treatments would only be used on a smaller group of people.

“These drugs are expensive. Some of that is the real cost of developing them and some of that is if you are only going for a subset of cancer then your total predicted sales will be less,” Prof Cameron told The Scotsman.

“The business model of the company will be that in order to develop the money to develop the drug your subsequent sales in the patent lifetime have to be sufficient to cover all your costs.

“So actually, the cost for rarer cancer is likely to be higher and not lower.”

He added: “The issue is, is the NHS willing to put more money into treating patients with incurable cancer, even if they keep them alive for a reasonable amount of time?

“I don’t know if there is the political will to invest that extra resource.”

Prof Cameron said that the cancer drugs bill had risen “several fold” in the past 20 years, but was still not the biggest part of the overall drugs budget.

“But I can imagine it will go on rising at notable percentages each year, if all the drugs come through,” he said.

“Some of the increase in costs will be because more patients are getting the diseases. But if we do get the more targeted, effective therapies that we all want and research is suggesting we may start to see, don’t think this is going to save the NHS money in the next five years.

“I don’t think it will. It will cost the NHS real money, but it will buy real benefits.”

A Scottish Government spokeswoman said: “Scotland has robust, equitable and transparent arrangements for the introduction of newly-licensed clinically and cost-effective medicines, including cancer drugs, through the Scottish Medicines Consortium and Healthcare Improvement Scotland which operate independently from the Scottish Government.

“These focus on equity of access to newly-licensed drugs throughout Scotland, on the basis of their clinical and cost- effectiveness.”