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Costly anticancer drug gets first-line approval

Patients with the most serious form of skin cancer will have early and affordable access to the hugely expensive life-prolonging treatment Yervoy following its listing as a first-line treatment with the Pharmaceutical Benefits Scheme.

The drug, which harnesses the body’s immune system to fight the cancer, has been shown to extend the lives of some patients diagnosed with advanced melanoma by up to a decade, but until now its massive cost – more than $120,000 for a course of treatment – has limited its use.

But manufacturer Bristol-Myers Squibb said its listing as a first-line treatment gave treating doctors more options to attack the disease sooner following diagnosis.

In a statement from the drug company, specialist medical oncologist at Cairns Hospital Dr Megan Lyle said advanced melanoma was a very aggressive cancer, and average life expectancy following diagnosis was six to nine months.

But a study published in the Journal of Clinical Oncology in February found the median survival rate among 1861 advanced melanoma patients treated with Yervoy (the brand name of ipilimumab) rose to 11.4 months, and around one in five survived for three years.

 The study’s authors said the results “add to the evidence supporting the durability of long-term survival in ipilimumab-treated patients with advanced melanoma”.

“Yervoy is the first registered treatment to demonstrate long-term survival in some patients,” Dr Lyle said. “Oncologists can now offer patients the chance to access this potential benefit when they are newly diagnosed.”

Unlike drugs that directly attack the tumour, Yervoy works to recruit the body’s immune system to attack the disease by enabling the activation and proliferation of immune cells.

Yervoy is among a number of very expensive treatments that have appeared on the market in recent years, prompting governments to cast an increasingly critical eye over their performance and claimed benefits before deciding whether to subsidise supply.

To help manage the risk, the Australians Government in 2010 introduced the Managed Entry Scheme, under which high cost medicines can be dropped from the PBS if they do not perform as expected.

In 2013, Yervoy’s manufacturer become the first drug company to agree to provisional listing under the arrangement.

Swirling controversy about soaring medicine costs has been fuelled by a US study that has found drug companies are charging increasingly astronomical prices for cancer-fighting drugs according to what the market will bear rather than what they cost to develop.

An investigation by American health economists indicates prices of new medicines are being set by reference to the cost of existing drugs, resulting in an upward spiral of charges that has seen the value of the global anticancer drug market soar to $116.6 billion in 2013.

The Journal of Economic Perspectives study, based on pricing trends for 58 anticancer medicines approved for use in the US between 1995 and 2013, found that the launch price for medicines were growing by an average of 10 per cent a year, forcing patients and insurers to pay increasingly higher amounts to extend lives.

Across the sample of drugs included in the study, the average cost of each year of life gained soared from $69,000 in 1995 to $178,000 in 2005, before reaching $265,500 in 2013.

Adrian Rollins