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Sovaldi ‘unaffordable’ says NHS documents

Published on 07/10/14 at 08:42am
Sovaldi pack shot
Gilead's Sovaldi costs £35,000 for a course of treatment in the UK

Senior health officials may have to bar Gilead’s new hepatitis C pill Sovaldi from being funded on the NHS after new data shows it would cost the health service £1 billion a year to fund.

This comes despite NICE saying in recent draft guidance that it is willing to pay for the treatment, which costs around £35,000 per patient, making it one of the most expensive drugs outside of oncology in the world.

On top of this, an additional £2,400 for Roche’s ageing injectable treatment Copegus (ribavirin) would also need to be added on as this is required for the full course of treatment.

NHS England’s specialist commissioning fund is currently paying £18.7 million for the drug as it is being assessed by NICE, with around 500 patients already gaining access to the medicine.

But according to the internal NHS documents seen by the Health Service Journal, NHS officials have written in a briefing note that the £1 billion estimated cost of providing the drug to 20,000 hepatitis C patients was ‘prohibitive’.

Recent clinical trial data show Sovaldi (sofosbuvir) can effectively cure the disease in over 90% of patients in just 12 weeks. This is compared to other treatments such as Vertex’ Incivek (telaprevir) and Merck’s Victrelis (boceprevir), which take double the amount of time to treat and have cure rates of around 75 per cent.

This could, theoretically, almost cure the disease in an entire patient population.

The efficacy of Sovaldi has also translated into astonishing sales – hitting over $2 billion in its first quarter for 2014 and $3.2 billion in its second – making it the fastest-selling medicine in the world and on course to break the $10 billion barrier by next year, should this trajectory hold.

NHS England, and now NICE, say that despite the price tag the drug is in fact ‘highly cost-effective’ as it can potentially help stop the need for liver transplants, which cost around £50,000 per patient.

But the NHS briefing document says these savings would not be seen for many years or even decades, and the £1 billion cost for 2015 alone would mean around 1% of the total NHS budget and 12% of the patented medicines budget would be going on just one treatment.

Given the fact that the NHS is set to be in a £30 billion deficit by the end of the decade and the government is already squeezing the drugs budget and other services, it will come as no surprise that this figure is simply unaffordable to the NHS.

There are other new hep C medicines on the horizon that combined with Sovaldi could increase cure rates further however, with rival firms also free to lower the price of their medicines to make them more appealing.

But Charles Gore, chief executive of the Hepatitis C Trust, questioned whether the drug was being singled out because the disease predominately affects disadvantaged groups.

“I doubt if this same affordability question would be there in the face of a cost-effective treatment for cancer,” he says.

Another leading doctor told the Independent newspaper that the NHS’ proposed course of action set “a dangerous precedent that the NHS is only going to treat people with severe diseases”.

Ben Adams

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