Health-e (Cape Town)

South Africa: Helping CML Patients Access Effective Treatment

Phamaceutical drug manufacturer, Novartis South Africa, has taken steps to make an important drug in the treatment of a rare type of leukaemia called chronic myelogenous leukaemia (CML), more accessible to patients who need it.

Patients in both the public and the private health care sectors will benefit from the move by Novartis South Africa to expand access to Tasigna, a drug registered for second line treatment in patients with chronic myelogenous leukaemia (CML).

For the first time in South Africa, the company is looking at making the drug easily available to CML patients who rely on government services for their health care needs if it is prescribed for them as an option. The high cost of the drug makes it inaccessible for patients in the public sector.

Currently, there are only 56 public sector patients on Tasigna. Some of these participated in clinical trials of the drug and others had the drug donated to them by the company on recommendations by oncologists.

"We are looking at broadening access in the state sector. We will engage with different stakeholders in government to ensure that on a shared contribution model we will make Tasigna available for all eligible patients. Novartis shared contribution models have been implemented in more than 81 countries around the world. They start from zero contribution up to sliding scales of contributions based on the ability to pay. Therefore, what we need to define in South Africa is exactly: What is the best solution for the future? Originally, it will be on a 100% free basis", says Yolanda Barnard, the business unit director for Oncology at Norvatis South Africa.

In the private sector, there are about 30 patients on Tasigna. These are patients who are using Tasigna as a second line drug either because they were resistant or suffered severe side-effects from the first line drug, Glivec. Medical aid patients will also breathe a sigh of relief as Novartis South Africa has reduced the cost by almost 50%

"We will be taking a significant price reduction of 46% in the private sector. The reason for that is truly that we believe that this is an emerging market. We do understand the dynamics of this market and, therefore, we are reducing the price of Tasigna. We believe that this is the best possible care for patients and as many as possible patients that are eligible for this drug should be able to be treated with the product", says Barnard.

In rands and cents, the 46% reduction actually means that "it will basically be a reduction of R15 000". The current cost of the product is R33 450. The new price for Tasigna will be R18 085. 45", she explains.

The cost quoted excludes tax. Inclusive of VAT, a monthly pack of Tasigna - taken orally twice daily as life-long treatment - will now cost about R20 600.

The Cancer Association of South Africa (CANSA) has welcomed Novartis's move to expand access to the drug.

"We are very much appreciative of that because the situation with this drug is that it prolongs the period of time the patient would be in survivorship over quite many years because it suppresses the cancer. Where other drugs fail, this one is most likely to succeed. However, it is not in the government's formulary for medication of cancer patients and it is very expensive. It can cost a patient up to R35 000 a month just to be on this drug. If you are on medical aid, in order for you to be able to receive this drug, you have to be at the high end of the medical aid scheme to be able to have this drug. So, it becomes prohibitive for an ordinary person who really needs this to be able to get it", says the organisation's head of advocacy programmes, Joel Perry.

Perry appealed to medical aid companies and the government to support efforts to make the drug widely available.

"It is now an opportunity for government to look into this matter and see to what extent they will be able to bring this drug as part of the regime for patients. Medical aids have their criteria for determining what drugs they cover and to what extent. With this significant reduction, it is for them now to show generosity.

And more than generosity, it is people's money that is put into the medical aids. So, it is an opportunity for them to relax the criteria and make it much more inclusive for many more people so that they can benefit because, really, the ordinary man will not be able to afford the cost for cancer treatment as a whole. It is very much prohibitive", he said.

Tasigna is prescribed for use in adults. If first line treatment drugs fail patients, there is very little hope for their survival. Chronic myelogenous leukaemia is not a high prevalence disease and accurate statistics are not available, but it's estimated that about 1 200 South Africans are being treated for the disease.

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