Cancer drug no longer free for new Irish patients

State considering cost-effectiveness of Nivolumab but drug still there for those currently taking it

Pharmaceutical giant Bristol-Myers Squibb (BMS) had made the drug available for free to cancer patients last month in response to an appeal by Minister for Health Simon Harris for “compassion”. File photograph: Dave Meehan/The Irish Times

A life-saving new cancer drug will no longer be available for free to new Irish patients after its manufacturer discontinued a compassionate access programme while the State considers whether or not the drug would be cost effective to provide.

Pharmaceutical giant Bristol-Myers Squibb (BMS) made the drug available for free to cancer patients last month in response to an appeal by Minister for Health Simon Harris for “compassion” while the Government mulls a decision on its approval.

About 200 patients received the drug known as nivolumab free under the programme. All patients currently receiving it will continue to do so, but the latest announcement means no additional patients will be provided with the drug.

A spokeswoman for BMS confirmed “the closure of the compassionate access programme on June 30th”, but added it was in talks with the HSE on its approval and that it hoped “access for Irish patients will be granted as soon as possible”.

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Previously rejected

Nivolumab was previously rejected on cost-efficiency grounds by the National Centre for Pharmacoeconomics (NCPE), which carries out cost benefit analyses of medicines for the State.

BMS has since submitted a revised price proposal to the HSE for the drug, and NCPE director Prof Michael Barry on Thursday night said it was under consideration.

He said the drug can be used to combat five different cancers, and that the centre had completed its analyses in relation to two of these. It concluded the drug is “not cost effective in relation to other therapies”.

“We’ve completed our review with two cancers and we’ve said we do not recommend it at the submission price,” he said. “The other three are still under consideration.

“We are glad that people who are currently on the drug will continue to receive it, but, for those who are not on the drug, the review process is under way. We’re looking at a time frame of about 90 days for us to produce our report.”

Depending on the type of cancer, the cost of the drug would range from €50,000-€100,000 per patient per annum.

A spokesman for the Department of Health said its position on the matter was unchanged. “The Minister asked the manufacturer to show compassion and to reopen the compassionate access scheme to patients during the assessment process,” he said.

“That remains the position. The operation of the scheme is at the discretion of the manufacturer.”

The drug has been found to significantly extend survival rates for patients with kidney cancer. A separate study found nivolumab helped reduce lung cancer tumours when used with the longer-established drug ipilimumab.

Colin Gleeson

Colin Gleeson

Colin Gleeson is an Irish Times reporter