Competition Commission gets facts wrong about drug companies

The Competition Commission is investigating Pfizer for charging excessive prices for a lung cancer drug in SA. On Tuesday‚ the commission stated it was investigating three pharmaceutical companies for “excessive prices” for cancer drugs.

But the commission made several mistakes‚ including getting the name of Pfizer’s drug wrong.

The commission did not note that all drug prices are approved and signed off by the medicines pricing committee within the Department of Health. The commission also said it had information that gives “rise to reasonable suspicion that Pfizer has and continues to engage in excessive pricing conduct in provision of crizotinib”. Pfizer confirmed that crizotinib is not registered in SA.

Picture: RUSSELL ROBERTS

Picture: RUSSELL ROBERTS

An unregistered drug cannot be sold in the country and will not have a price. The commission complained about its R152‚000 price saying it was in possession of information that this treatment was “unaffordable”. Pfizer denied this price.

Wits oncology professor Paul Ruff explained that a handful of patients accessed this drug using a special Section 21 permit to buy it overseas and import it, because it is not available here. Medicines only get a set price after they are registered in the country‚ he said‚ so crizotinib has no local price or supplier.

The European Commission is investigating Aspen for a 1‚500% increase for a 50-year-old leukaemia drug in the UK and a 4‚000% increase in Spain. On Tuesday, the commission said it would also investigate Aspen saying it was in “possession of information that Aspen had engaged in the same conduct locally”.

However‚ it failed again to note all price increases for all drugs are set annually by the department of health.

Aspen confirmed that the drugs under investigation have increased, on average, 6.25% since 2009 when Aspen bought the drug portfolio from GSK. The commission said Aspen’s drug prices may be “excessive”. The drug used for leukaemia‚ Leukeran‚ costs between R2‚800 and R4‚800 a month per patient.

Myleran‚ used for a blood cancer‚ costs an average of R2‚086 a month but the dose and price will drop after a few months if the cancer goes into remission‚ said Aspen’s spokesman Stavros Nicolaou.

The commission also took issue with Roche’s cancer drug which costs R500‚000 in the private sector for a year’s course. The commission said people couldn’t access the drugs and charged Roche with “exclusionary conduct”. But this drug is to be provided to state patients at one of the lowest prices in the world within months‚ two sources close to the Roche and department of health negotiations said.

Roche said recently it believed a deal with the department on supplying this drug to state patients was “about to be finalised” saying negotiations were “advanced”.

Two sources also confirmed that the commission didn’t even call the department of health to get its views on the matter or check the commission’s facts. All three pharmaceutical companies learned of the investigations through the media statement.

The commission also charged Roche with “price discrimination” because it has a state price and a private-sector price for cancer drug Herceptin. However‚ the Medicines and Related Substances Control Act allows the prices for medicines for state patients and private patients to differ and‚ in fact‚ a high private price is used to subsidise very low state prices for nearly all medicines in the country‚ two industry sources confirmed.

The commission did not respond to requests for clarification.

In a Sens statement on Tuesday, Aspen said all the drugs under investigation for excessive pricing sell for less than R3m a year combined.

 

As overdose deaths hit record levels, drug and alcohol services face massive cuts

former heroin addict, works as an advocate for Naloxone, a drug that reverses opiate overdoses. Photograph: Martin Godwin for the Guardian

Kevin Jaffray had been addicted to heroin for 20 years when he finally sought help in prison. “I was in prison more than out. I’d been living in a tent in Bournemouth. I’d lost everything, I was broken. I was overdosing once or twice a week. I was dicing with death every day. Prison was a relief.”

He approached a Luton-based 12-step recovery organisation for help and spent 11 weeks in residential rehabilitation. “I’d got to the point where my body couldn’t take it any more. We had groups and individual therapy. They helped me with my health and criminal charges. I was living with old friends. They had got clean and it inspired me to change.”

This was back in 2006, when drug funding was at its height under the Blair government. Jaffray was accepted for treatment after a single phone call. Now clean for 11 years, Jaffray, 49, has rebuilt his life. He was employed as a drug worker in Bedford between 2008 and 2015 and now works for the national Naloxone Action Group as an advocate for Naloxone, a drug that reverses opiate overdoses.

He says he was “very lucky” to have been trying to get clean when he was. At one time, he’d been given just three months to live by his doctors.

By 2015, Jaffray says his caseload in Bedford had gone up to 60 people a fortnight compared to 20 people three years earlier. He said access to treatment had completely changed. “Only one or two people in each area was getting awarded the funding to go into rehab and a hell of a lot more people than that were requesting it.” That year, drugs deaths in England and Wales reached their highest levels since records began in 1993.

The UK is now officially the drugs overdose capital of Europe with almost one in three of the continent’s overdose deaths, mainly related to heroin and other opioids, according to the European monitoring centre for drugs and drug addiction. Its 2016 annual report, published last week, which also aggregates data from Turkey and Norway, found the UK also had the highest proportion of heroin addicts. About eight in every 1,000 Britons are high-risk opioid users. Yet despite drug overdoses hitting record levels, an investigation by the Guardian has found that 11 local authorities in England, both those who were projected to cut most and least, have made average cuts of 17% between 2015-16 and 2016-17, more than £15m in total.

Collective Voice, an umbrella group of leading UK addiction charities, including Addaction and Turning Point, fears however that cuts to council drug treatment services funded by central government are far worse in some parts of the country. “Local authority funding has seen cuts of 25%, 30% or 40%: this has an impact on councils’ ability to fund drug and alcohol treatment,” says Paul Hayes, chief executive of Collective Voice. “At the same time, the needs of the drug-addicted population are increasing, particularly among the frail and ageing cohort of heroin addicts who started using in the 80s and 90s.”

Staffordshire county council has made cuts of 45% to its drug and alcohol treatment budget over the past twoyears. Local drug services campaigners claim 1,500 fewer addicts will receive treatment every year as a result. Alan White, Staffordshire council’s cabinet member for health, said it was left with no choice after its local clinical and commissioning group pulled an expected £15m of NHS funding for drug and alcohol services. “In 2015-16 we had to make some very difficult decisions on funding in order to protect services we have a statutory duty to provide,” he says. “We have worked with providers to help ensure a safe service can still be provided with the budget we have available.”

In Barnsley, where seven people this year have already died of drug overdoses (possibly due to contaminated heroin), the council cut its drugs and alcohol services budget by more than a third between 2015-16 and 2016-17. The authority’s own documents make it clear that some services will be “unavailable” after the cuts and that a number of drug workers will be made redundant. Jayne Hellowell, Barnsley council’s head of commissioning, healthier communities, says that services have merely been “reorganised.”

Even in Middlesbrough, which has the third highest level of drug-related deaths in England and the highest level of heroin use in England, drug misuse services haven’t been spared. The council cut the budget by £1m last year. Rachel Burns, Middlesbrough council’s health improvement specialist, says: “Our financial position has meant that we have actually reduced our overall substance misuse budget from £5.39m to £4.39m”.

“We were recommissioning our drug treatment services so we realised substantial savings by combining our youth and adult services, and housing all the substance misuse services into one building.” She added that redundancies were kept to a minimum and no frontline staff have lost their jobs.

The cuts are the legacy of ending what had been an effective ringfence on drug treatment funding in 2013 and the transfer of responsibility for funding drug and alcohol treatment from the NHS to local authorities. Deaths involving heroin and morphine more than doubled between 2012 and 2015. Government figures show that in 2015 more than twice as many people were killed by fatal drug overdoses in England, Wales and Scotland, in total 4,380 than in traffic accidents at 1,732.

Vanessa Fearn, a researcher at the Office for National Statistics, has said that age is a factor in the record level of drug deaths “as heroin users are getting older and they often have conditions such as lung disease and hepatitis that make them particularly vulnerable”. But Hayes insists that although the relationship between funding and drug-related deaths is complex, there is a connection. “The most important thing we can do to prevent further increases in drug-related deaths and to get a grip on recent increases is to continue to invest in treatment,” he says. “The more we disinvest in treatment, as we are doing at the moment, the more we will put increasing numbers of people at risk of early avoidable deaths.”

Jaffray says that because of the pressure on treatment providers to get good results, those who are most in need are being turned away. “The more desperate and chaotic you are, particularly if you have underlying mental health problems, which 75% of addicts do, the less chance you have of getting support because you’ll be a burden on their statistics and on their books for a long time. This is having an effect on the most chaotic people in the community: they are dying.”

Could this new drug give you a real sun tan?

Scientists say they have discovered a drug that could give you a real sun tan without even stepping outside.

The drug gets the body to create melanin the pigment which is the body’s natural protection against ultraviolet rays in sunlight.

But the experts at Massachusetts General Hospital in the USA say their findings is not so much for cosmetic use – but could have a “huge” impact in cutting skin cancer rates, BBC News reports.

Image result for Could this new drug give you a real sun tan?

The drug has only been tested on mice so far, but there are hopes it could reduce both sunbed use and the risk of burning for people tanning in the sun.

Dr David Fisher, one of the researchers, said they would like to see the drug combined with sun cream and made widely available in future.

Council chiefs say skin cancer is a serious problem in Liverpool, launching a national campaign against sunbed use in 2013 after finding half of teenage girls had used one.

Dr Paula Grey, the city’s public health director at the time, said: “Girls in Liverpool like to look tanned. We haven’t got a problem with that. It’s how you get the tan.

“It’s just not worth using sunbeds. There will be girls of today who in 20 years’ time will develop skin cancer.

“But we have even seen examples of girls in their 20s developing melanoma, and we are expecting to see rates rise.”

Michelle Purchase, from Prenton (Photo: James Maloney)

Tributes were paid to a young woman from Prenton who died of skin cancer last month after bravely speaking out about the disease.

Michelle Purchase, a healthcare assistant, was widely praised for a heartfelt warning she made just weeks before her death about the dangers of sunbeds she had used as a teenager.

Matthew Gass, from the British Association of Dermatologists, told the BBC; “A lot more research has to be done before we see this sort of technology being used on humans, however, it’s certainly an interesting proposition.

“Skin cancer rates in the UK are going through the roof… any research into ways that we can prevent people from developing skin cancer in the first place is to be welcomed.”