The first paragraph summed it well – drastic price reduction would enable more breast cancer patients with HER2-positive to be treated with trastuzumab.
Trastuzumab treatment is heavily subsidised for patients who fits certain criteria in government hospitals. For these patients, this news won’t affect them.
Who will it benefit then?
Besides adhering to KKM drug formulary indications for trastuzumab usage (HER2-positive, adjuvant setting, high-risk), government hospitals tightened its use further (due to budgetary constraint, sustainability) by introducing age-limit, hospital quota (max number of patients per year) and indications (high risk, non-metastatic).
If those constraints are removed, I foresee many more breast cancer patients will benefit from this treatment, which helped to improve cure rate and survival.
In Malaysia, there are about 5000 breast cancer cases yearly, and around 1/3 are HER2-positive in various presentations (young, elderly, high-risk, low-risk, adjuvant setting, metastatic setting).
I cautiously hope that the increase of trastuzumab usage will be at least by a factor of 2 (double) with the removal of certain ‘limitations’ of its use.
Drastic price reduction
The Malaysia Competition Commission’s Market Review on Pharmaceutical Sector under Competition Act 2010 revealed that trastuzumab (440mg per vial) cost RM6,170 (Health Ministry’s contract price before the latest price drop) while the average price from three private hospitals is RM8,658. ~ TheStar 15/4/2009
The new price to government now is around RM3000 per vial of 440mg.
I’m sure private hospitals will start demanding significant price reduction also and in the process also benefit more patients.
The impetus for the price reduction was the entry of trastuzumab biosimilar in Malaysia and new tender called last year.
I heard that the tender will lock the price for 3 years (if I’m not mistaken).
I’m just wondering if yearly tender will be more advantageous to the government instead as pharmaceutical companies will try to out do each other every year.
This will translate to even lower price for the medications and more patients can use it (maybe available to use in government hospitals for metastatic setting also, someday).
Allow more generic/ biosimilar in?
Besides calling for more frequent tender, perhaps allowing more generic or biosimilars in the market will help to trigger more price reductions for other expensive oncology (and also non-oncology) medications.
To achieve this, we need to speed up regulatory approval process.
From what I heard, they are fairly slow.
The government is heading towards the right direction (more competitions, lower price, more patients benefiting).
The expectations of the public is high, which is to remove all criterias/ limitations of trastuzumab usage in HER2-positive breast cancer.
However, Malaysia is not a rich country.
So, the only way to allow more patients to benefit from this treatment is for the treatment to be more affordable and wait for the price to drop further.