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Celgene threatens to scale back UK clinical trial investment after CDF snub

Published on 04/09/15 at 03:47pm

One of the world’s leading pharma companies in oncology is considering whether to continue investing in clinical trials in the UK, as it cannot justify the expenditure in the face of cuts to the Cancer Drugs Fund.

Two of Celgene’s treatments for multiple myeloma, Revlimid (lenalidomide) and Imnovid (pomalidomide), and its pancreatic cancer treatment Abraxane (nab-paclitaxel), have been de-listed from the CDF in the latest round of funding cuts by NHS England.

Abraxane is indicated for first-line use in advanced pancreatic cancer when used in combination with gemitabine. Pancreatic cancer is the tenth most common cancer in the UK, with almost 9,000 new diagnoses every year.

The decision also means that some patients with relapsed and refractory multiple myeloma in England will not be able to access treatment. Patients in Scotland will be able to receive both treatments and the All Wales Medicines Strategy Group (AWMSG) approved Imnovid for use on the NHS in Wales last month.

All CDF decisions will come into force from 4th November 2015, after which NHS England will no longer fund delisted treatment for newly-diagnosed patients. The decision has been forced by the spiralling cost of the Fund, from £200 million in 2010 to £340m in 2015/16.

Wim Souverijns, general manager of Celgene UK and Ireland, said the decision to ‘arbitrarily remove’ funding for cancer drugs meant NHS England “has created a scenario where life sciences investment and innovation in the UK is being put in genuine jeopardy” – and meant England risked falling further behind the rest of Europe’s cancer survival rates.

He told Pharmafile.com: “We do recognise that from the inception the CDF probably was not the ideal way to manage access. It comes as no surprise that the system isn’t working. I do have sympathy with the CDF panel; they are massively overspent and have to pull it back somehow. My issue though is the impact these decisions have on patients.

“Internally we have got a lot of pressure from the global company. Celgene is saying ‘we invest so much in the UK and England, we’re doing a lot, and it's becoming hard to justify’. We’re feeling a bit hammered by these targets for savings that the NHS has to make.”

Souverijns warned Celgene, which sponsors trials that include 15,000 cancer patients, is considering whether to continue recruiting UK patients for its clinical trials. Major relocation by companies could leave patients in England 'years behind in getting new treatments’, he adds.

“I have put a hold on any clinical trials, because I want to see if there’s room to discuss these challenges with NICE, with the Department of Health and with the Government.

“The challenge I have as a managing director in the UK is that my peers are going to make higher revenue for their investments in other countries. The question Celgene is being forced to ask is: ‘Why would we invest [in the UK] when I can invest in France, or in Germany, instead?

“We have a choice where we are going to conduct these trials. If there’s no improvement we’re going to make that decision. We will continue with existing trials, but for new studies, there’s a question mark.”

Souverijns suggested the sentiments are shared with other companies that had lost NHS England funding, and that the situation is reaching a 'tipping point'.

“I have been talking to some of my colleagues and the one thing other companies in the CFD round say is, it’s going to be a bloodbath. Companies basically said ‘we’re not going to be giving away anything more’. But my sense is that the NHS is willing to take the hit. I think it’s a stalemate.”

His concerns are shared by Eric Low, chief executive of Myeloma UK, who told Pharmafile.com: “We get feedback from pharma companies that England is seen as quite a hostile place to do business. If they don’t get reimbursed for drugs then their revenues are slashed dramatically. It only makes sense that people go to other places and other countries where they get more funding. In clinical research in the UK, companies are becoming increasingly frustrated. But pulling out would have a huge impact on patients.

“It’s almost incalculable the cost of this debacle and the Government’s inability to put drivers in place to secure access for cancer treatments is having. The NHS is trying to take cost out of a system that’s not working. But what they’re not doing is thinking about the downstream cost. The industry needs to hang its head in shame too because they have not come up with a way to work with the Government – and patients are paying the price.”

Ali Stunt, founder and chief executive of Pancreatic Cancer Action, called the decision to de-list Abraxane ‘extraordinarily disappointing’, and said she feared for people with the illness – 83% of whom live in the UK.

“Pharma companies are not charities, they are commercial organisations. But I do feel the inability for some sense from both parties – pharma companies and the Government – to prevail is quite extraordinary. We have problems with the number of trials available for pancreatic cancer patients; these are few and far between and there are probably only about 65 in the world looking at Abraxane.

“It’s not just Celgene. I’m concerned about the knock on effect on other companies and the trials they sponsor. I can understand that pharma companies will be looking again at whether to continue with their investment. But it would be simply disastrous for patients to be denied because oncologists could not access a drug.”

The newly-published Cancer Drugs Fund list can be viewed in full here.

Lilian Anekwe

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