Drastic cancer drug price drop to benefit patients

KUALA LUMPUR: The price of the costly trastuzumab, a breast cancer drug for HER2-positive patients has dropped by more than half in the tender to the Health Ministry, resulting in more patients expected to be treated in the ministry hospitals.

According to industry sources, the originator pharmaceutical company has dropped the price of the drug by about 52% in a tender approved by the ministry after a local drug company brought in a biosimilar version of the drug – the first in Malaysia – that costs about 50% of the original price.

The Health Ministry called for a tender at the end of last year and it was recently awarded to the originator company, said an industry source.

Patients treated in the ministry’s hospitals are subjected to the Fees (Medical) (Amend­ment) Order 2017, while patients in private hospitals pay around RM130,000 for a year’s treatment (17 cycles) before the price drop.

Overall, the patients in private hospitals are also expected to benefit from the reduced price because the originator pharmaceutical company is likely to offer a similar price to biosimilar or lower.

HER2-positive patients have aggressive cancer cells – these patients are tested positive for the protein human epidermal growth factor receptor 2 (HER2) which promotes cancer cell growth.

In August last year, The Star reported that the biosimilar of trastuzumab was approved by the United States Food and Drug Adminis­tration in December 2017 but oncologists here complained that the Malaysian authorities had been slow in registering the drug, which could benefit patients who wanted the targeted drug therapy.

Deputy Health Minister Dr Lee Boon Chye then promised to expedite the approval of the biosimilar registration and in December last year, Health Minister Datuk Seri Dr Dzulkefly Ahmad said it had been approved.

It was reported that some 5,400 new breast cancer patients were diagnosed every year and one in five patients were HER2-positive patients.

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.

Health director-general Datuk Dr Noor Hisham Abdullah said the price reduction would increase trastuzumab accessibility to patients.

The National Medicines Policy (Access to Medicines component) advocates accessibility and affordability of medicines, he said.

“With the available budget provided to the ministry, a higher volume can be purchased, hence, more patients will benefit from this,” he said.

Dr Noor Hisham said the approved tender for trastuzumab was by the original brand – as the price was lower than the biosimilar product that bid for the same tender which was conducted as open tender, in keeping with the government’s procurement process.

“The price is also significantly lower as compared to the previous tender,” he said.

He said the drug is available in the ministry’s specialist hospitals that offer oncological services.

Dr Noor Hisham said patients will pay treatment charges according to the current fee schedule of the Fees (Medical) (Amend­ment) Order 2017 – based on treatment cycles.

He said no payment is required for the medicine per se, but the charges are bundled with the treatment process when receiving the medication, adding that the drug will be provided to suitable patients as prescribed by specialists and subjected to availability of funds within the hospital.

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