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Balancing innovation and affordability in drug development

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Prof. Stephen O’Brien

Consultant Haematologist, Newcastle Hospitals NHS Foundation Trust

The huge advances in treatment for patients with chronic myeloid leukemia has transformed patients’ lives, but the challenge is balancing innovation and affordability.


“Improvements in the treatment of chronic myeloid leukaemia (CML) is one of the greatest success stories in cancer treatment,” says Prof Stephen O’Brien, Consultant Haematologist at the Newcastle Hospitals NHS Foundation Trust.

Just 20 years ago, patients with CML could expect to live for around five years. Today, some are completely cured and others can live a normal life on medication.

Not only are survival rates impressive, but the fact that the drug can be taken in tablet form at home has revolutionsed the way that cancer patients are treated.

One patient, who’s a farmer, receives his medication when he’s out on his tractor.

“Follow-up calls can be taken at home, patients don’t have to take time out of their lives to come to an institutional setting and we even have one patient, who’s a farmer, who receives his delivery of medication when he’s out on his tractor,” says O’Brien.

Of course, the benefits all come at a cost and, when they first arrived on the market, treatments for CML cost in excess of of £20,000 per patient per year.

Considering the majority of patients are on the tablets for the rest of their lives, the cost was significant. However, the patent expired in 2017, which means the drugs are now available for hundreds of pounds a year – a fraction of the cost.  

This is clearly a positive step forward, but the tension between innovation and affordability remains ever-present. “As a clinician and scientist, this is a really exciting time,” says O’Brien. “But as a citizen and Chair of a NICE Technology Appraisal Committee, I’m acutely aware of the costs. We have to be stringent in evaluating new technology and drugs to ensure the best outcomes for patients and ensure affordability for the NHS.”

 

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