Yes?

“Breakthrough” cancer drugs that can extend lives are taking 22 years to reach patients on the NHS, a major study has found.

The research by British scientists found that the most innovative treatments – which can radically overhaul the way diseases are treated – take far longer than conventional drugs to get the green light.

The study by the Institute of Cancer Research examined all cancer drugs licensed by European watchdogs over a 16-year period.

It found that between 2009 and 2016, it took an average of 14 years for treatments to go from a patent being filed to it being available on the NHS. The situation was even worse than it had been between 2000 and 2008, when it took 12.8 years.

The more innovative a drug was, the longer it took to be funded on the NHS – on average, taking just over three years longer than conventional treatments to get to patients.

All new drugs take 10 to 12 years from patent date to general approval and use. That’s just how long the approval process (EMA, FDA, whatever) takes. The NHS might be even slower than that, sure, but that’s not the major issue here at all.

Then this:

Cases highlighted in the study include a drug called trabectedin, which can extend the lives of those with advanced soft tissue carcinoma.

It took 22 years from the drug being patented to getting the go-ahead from the National Institute for Health and Care Excellence.

Another drug used to treat bone cancer took 20 years to reach this stage,

That’s drugs falling out of patent, dropping in price by 80 to 90%, then the NHS being willing to pay for the presumably marginal benefit – it now meets the £50k per Qualy for cancer drugs.

Hey, maybe the NHS is worse than others. But the real time killer here is the general approval system.

10 thoughts on “Yes?”

  1. There’s also all the clinical trials that need to occur between patent application and launch. They take time. If you want to show, e.g. improvement in survival, you need a study period of >2 years per patient with all the admin and set up either side. And that would typically be the last trial, prior to which you would have conducted multiple safety and dosing tests. We only know the drugs are life saving after this has been done so not sure how to fix that

  2. I’m pretty sure the same people would be complaining if the NHS started prescribing drugs that turned out to have serious safety issues.

    Its obviously going to be much easier and quicker to prove the safety of incremental drugs where can point to the body of evidence of other similar drugs and what is known about the long term effects of them. An innovative drug will need a wider ranging analysis and extra data to convince regulators that it really is safe.

    There do seem to be inefficiencies within the process – each country has its own regulator making its own decision requiring trials run to the local standards. Some of that however is undoubtably down to the fact that different populations react to drugs differently and have different risk factors. Some of it is probably regulators not trusting other countries to not be ensnared by local the drug companies and actually do the job properly

  3. The only way to be certain we don’t have another Thalidomide would be to test new drugs on pregnant women (testing on animals takes you only so far), and who would volunteer for such a test? Of course, we can do a lot more in vitro (and in computero) than we could in the 50s/60s.

  4. @Chris Miller
    I wonder why I feel queasy at the thought of growing embryos for the sole purpose of testing drugs on them. Terribly old fashioned of me I know.

  5. There’s a fast way to get your drug approved when its purported purpose is to protect you from heart attacks. All you have to show is that it reduces cholesterol in the blood. It’s then taken as axiomatic that it protects you from CVD and extends your lifespan. Even though there’s good evidence that the axiom is tripe.

  6. The approval system exists to keep people from being harmed. It does not exist to approve drugs.

    People like fascism. Throttling development is good because it saves lives. Their lives. They are more concerned about themselves than your aunt’s cancer.

  7. My mother was offered Thalidomide. She turned it down. If she had never done anything else for me that would have been enough.

  8. I was in a drug trial over 20 years ago. Testing to reduce migraines.
    Of the 3 guys I met over the many weeks of testing – one dropped out due to being transferred in his job overseas. One died in a traffic accident (not due to the drug, he was a passenger) and one developed another health issue making him ineligible for the test.
    I don’t have migraines now.

    The drug never passed human testing as it stood. So 10 years or so of money wasted. I think it was a good use though. 🙂

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