Drug firms ‘put lives of cancer patients at risk’ as out-of-patent prices are inflated

Drug companies have been accused of profiteering by raising the prices of out-of-patent cancer medicines that cost just pence to make, inflating the bills of the cash-strapped NHS by hundreds of millions of pounds.

Academics say the prices of 14 cancer drugs have increased by between 100% and nearly 1,000% over the past five years in the UK. These are all generic drugs where the patent has expired, which means they can be made for little more than the cost of the raw ingredients.

But, say experts who presented their findings at the European Cancer Congress in Amsterdam, generic drug companies have been price-gouging, just as Turing Pharmaceuticals was found to have done in the US with Daraprim, a 70-year-old drug used in Aids treatment. The price rose from $ 13.50 to $ 750 to universal outrage and became an issue in the presidential election. Turing CEO Martin Shkreli was dubbed the most hated man in America.

Andrew Hill from the department of pharmacology and therapeutics at the University of Liverpool, said the price increases in the UK would be costing the NHS a huge amount of money at a time when it has said it may have to ration 20% of the very expensive new cancer drugs coming on the market. “This figure will probably be in the high hundreds of millions of pounds per year, or possibly £1 billion,” he said.

He and co-author Melissa Barber, from the London School of Hygiene and Tropical Medicine, funded by the World Health Organisation and the Open Society Foundation, could not calculate the exact costs to the NHS because they did not have access to data from hospitals, where cancer drugs are usually prescribed. But they also looked at the increase in prices of all types of generic drugs – not just cancer – that are prescribed by GPs and pharmacists and found that the NHS paid £380m more in 2015 than it had five years earlier, as generic companies pushed up their prices. The hospital bill is likely to be much more.

Hill said the rises were going unnoticed because they were “under the radar”. The NHS was not keeping an eye on the steady increases year on year. “They are not negotiating well enough,” he said. “They should be looking at any company that starts raising the price of any drug.”

Among the drugs with price rises is melphalan for ovarian cancer, a drug invented by the UK company GlaxoSmithKline and then passed with a number of other cancer drugs that were going out of patent to Aspen Pharmaceuticals, a South Africa-based generics company, in 2009. GSK took a 16% shareholding in Aspen at the time.

Hill and Barber say the price of melphalan in the UK went up from 55p for 2mg in 2011 to £1.82 in 2016, a rise of 230%. The NHS did not contest it, unlike in Italy. There, Aspen negotiated a deal in 2014 to raise the price of the drug by up to 1,500%, having threatened to stop supplying the ovarian cancer drug to patients altogether. The Italian competitions authority fined the company nearly $ 5.5m last October for its behaviour. “The negotiation strategy adopted by Aspen was so aggressive as to reach the credible threat of interrupting the direct supply of the drugs to the Italian market,” said the authority’s report.

Australia, New Zealand, France and Brazil have also faced shortages of Aspen’s drug, says Hill. Aspen did not return calls asking for the reason for the shortages.

In France, three women died after being given an alternative drug to melphalan. The drug, cyclophosphamide, should have been safe, because it was used before melphalan came on the market. An investigation is now under way into what happened.

The biggest price rise in the UK that the team found was also for an Aspen drug. The cost of busulfan for chronic myeloid leukaemia to the NHS rose from 21p for 2mg in 2011 to £2.61 in 2016, an increase of 1,143%.

Aspen’s share price rose more than 650% from 2009 to last year. GSK sold its shares in Aspen in three tranches – the last one in September – netting about £1.5bn.

The multinational giant Pfizer was fined £84m in the UK in December for conspiring with a generic company, Flynn Pharma, to raise the price paid by the NHS by 2,600% for an anti-epilepsy drug that came off-patent. The Competitions and Markets Authority said it had exploited the fact that the NHS had no alternative, because no other company was making it. In the wake of that case, a bill is going through parliament to give the Department of Health powers to investigate when the price of a drug goes up without clear justification.

Sarah Wollaston, the Tory MP who chairs the health select committee, said the research findings were concerning. “It is unacceptable for drug companies to artificially inflate the cost of drugs. This will inevitably result in less funding being available for other vital treatments,” she said.

Ian Banks, representing the patient organisation the European Men’s Health Forum at the conference, said the price rises were more than outrageous. “Behind these statistics there is a patient not getting treatment that could save their lives or at the very least improve their quality of life. That is unacceptable,” he said.

Mia Rosenblatt from Breast Cancer Now said: “We’d be extremely concerned by any suggestion of companies raising the price of tamoxifen and other generic drugs, which would only add to the current strain on the NHS.

“Part of the understanding – by health bodies – of the high cost of new drugs is based on the knowledge that there is a limited time for drug companies to see return on their investments and that these drugs will be available at a much cheaper rate in due course.

“Significant driving up of the prices of generic drugs would be of real concern and we therefore support the government’s activity to address this possibility through the Health Services Medical Supplies Bill.”

The British Generic Manufacturers Association said that most of the drugs highlighted in the study had no competition, because there was only one supplier. “That is because the total market size is too small to be attractive for generic companies to enter, since they would not recoup the million-pound plus costs of developing, testing and registering a new generic medicine,” it said in a statement.

Hill countered that the cost of developing a new generic drug is not high and that cheaper versions than those sold to the NHS could be imported from India.

Drug firms ‘put lives of cancer patients at risk’ as out-of-patent prices are inflated

Sufferers "put at risk" by programs to enable health-related students to deal with individuals

Ideas to let new medical graduates to deal with patients will place lives at risk, health care leaders have warned.

At existing, graduates have to complete a foundation year under the supervision of an knowledgeable physician prior to they can be registered with the General Health-related Council and licensed to practise independently.

Under strategies from the health-related coaching body, Wellness Schooling England, the GMC would register graduates as they leave university following five or 6 many years, freeing them to deal with sufferers without having even more supervision. Health-related leaders will raise issues at the British Health care Association conference in Harrogate this week, saying that the ideas will place patients’ lives at chance and jeopardise graduates’ employment chances.

The program was place forward to fix a crisis in the coaching of medical doctors where there is an oversupply of health-related students graduating and a shortage of basis yr coaching areas.

Harrison Carter, the co-chairman of the BMA’s students committee, explained: “Registering straight from medical college would indicate they are medical doctors in the legal sense and could perform as locums with no further schooling or supervision.

“They would not be on a coaching path in the direction of turning into a advisor or a GP but they could nonetheless operate as a physician here or overseas in a fairly dead-finish place. This compromises patient security as there is no ongoing education or supervision.”

Katherine Murphy, of the Individuals Association, stated safety could not be jeopardised at the expense of “fast-tracking” a doctor’s education.

A spokesman for Health Schooling England explained it had been asked to carry out an options appraisal for “a extremely complex area” and was discussing it with the Department of Health.

Sufferers "put at risk" by programs to enable health-related students to deal with individuals

Kids who see Happy Meal advertising "put burger and fries before wholesome choice"

The analysis raised questions as to whether fast food chains need to be in a position to promote to youngsters. Photograph: Alex Segre / Alamy/Alamy

Television adverts for McDonald’s healthier Content Meal deals fail to inspire kids to pick food that is greater for them and rather encourage a basic preference for quickly foods, academic study suggests.

The menu choices of youngsters aged seven to ten who watched a series of adverts for meals in which carrots and apple could exchange french fries had been not significantly calorifically lower than they otherwise may possibly have been. The youngsters exposed to adverts for the Satisfied Meals were, however, far more probably to express a liking for McDonald’s and rapidly food in general. The regulator Ofcom judges whether or not foods companies can advertise to kids on the basis of the nutritional worth of the items without having taking into account the boost adverts bring to rapidly meals brand names as a entire.

Dr Emma Boyland, of Liverpool University, who carried out the examine, explained the investigation into the selections of 59 young children, 6 of whom have been overweight and 5 obese, raised queries over no matter whether the big fast food brands ought to be allowed to market to kids. Shadow public well being minister Luciana Berger has previously proposed an overhaul of the rules.

Final week researchers at the Institute for Wellness Metrics and Evaluation at the University of Washington claimed that British ladies were the fattest in Europe – with 29.two% of those aged under 20 getting overweight and obese. It was also claimed that far more people in the Uk were obese or overweight than at any other time in the final 3 decades

In Boyland’s research, half of the youngsters watched 10 programmes with adverts for McDonald’s Satisfied Meals, whilst the other half watched the same quantity of programmes with toy adverts. Of those young children who had watched the McDonald’s adverts, 84% subsequently mentioned that they had a liking for quickly food. This in contrast to 76% of individuals who watched the toy adverts. The calorific material of the selections manufactured by these who had witnessed the Happy Meal adverts, in which healthy alternatives are celebrated, were not drastically distinct from the other group.

Boyland mentioned: “I think my study suggests that the marketing is not driving healthier alternatives. The youngsters did not see healthful options and feel ‘I will have organic milk and carrot sticks’. The huge vast majority chose fries and a soft drink. But we did inquire them how significantly they liked rapidly food in basic and following seeing the McDonald’s adverts their liking for quick foods went up. My interpretation is it drives improved liking of fast foods, not more healthy foods decision.”

Boyland additional: “It’s a massive debate then about whether we ought to let fast meals giants to market healthy alternatives. If it is promoting healthier stuff, that need to in concept be a very good thing, but if the brand is so effectively known for quick foods and, on the complete, folks are purchasing unhealthy alternatives from there, is that anything we must be cracking down on?”

Principles drawn up by Ofcom prohibit advertisements for foods and drink goods high in fat, sugar and salt to be shown in and about programmes exclusively produced for kids. The rules were very first launched in 2007 and extended in 2008. However, a additional analysis by Boyland suggests that the regulatory regime, described by the government as the most stringent in the planet, is not safeguarding kids.

During one,931.five hours of Tv watched by children, from Peppa Pig to The X Factor, Boyland recorded 56,162 adverts – a rate of 29.1 an hour. There had been six,664 food and beverage adverts in the examine period, broadcast at an typical charge of three.5 an hour. Quick-meals objects were the most heavily advertised meals (15.two%). Boyland said: “The aim of the regulations is to decrease the exposure to individuals type of adverts and influence on diet regime. Our data suggests that this has not genuinely took place.”

Boyland mentioned that another problem was that children’s programming, during which fast foods adverts are not allowed, was defined by the proportion of ladies and boys who observe rather than by the amount. She mentioned: “So there will not be advertising in the course of SpongeBob Square Pants,which will attract a one hundred% youngster audience of say a hundred,000 children. Nonetheless, such promoting is allowed during The X Factor with, for example, a ten% child audience, equating to a million children. A bus can be driven via the loopholes.”

McDonald’s was not available for comment.

Kids who see Happy Meal advertising "put burger and fries before wholesome choice"