Tata Memorial recommends 12 cancer drugs for price control

Tata Memorial Centre, the country's premier hospital and research centre for cancer treatment, has suggested the inclusion of 12 key cancer drugs in the National List of Essential Medicines (NLEM), prices of which are regulated by the government.

The institute's move to seek a reduction in drug prices comes in the wake of a spiralling of oncology drug prices and black-marketing in some essential medicines, especially those of MNC pharma companies, amidst a voluntary price reduction by some companies.

While the prices of 348 medicines are regulated by the National Pharmaceutical Pricing Authority (NPPA), there are only a few cancer medicines, prices of which are regulated by government. Some of these medicines are not so commonly used. However, there are several advance treatments coming up every day, and doctors feel there is an urgent need to make these medicines affordable to patients.

The NPPA, which is currently deliberating on the recommendations, has sought comments from various stakeholders, including patient groups and industry on the issue.

The 12 medicines that Tata Memorial Centre has recommended for price control include those used for the treatment of brain tumour, colorectal cancer, cervical, ovarian cancer as well as those used in treatment of breast, lung, kidney and prostate cancers.

Most of the medicines are used in multiple therapies or in the treatment of various cancers, such as Zoledronic acid, which has been found to reduce the incidence of skeletal-related events such as severe pain, fracture etc in patients suffering from multiple myeloma and a variety of solid tumors, including breast, lung, kidney, prostate etc.

However, there is a huge price disparity between branded zoledronic acid and its generic versions, which offers huge scope for price reduction, it was pointed out.

The institute has also suggested regulation in the prices of Letrozole, which is used mainly as an adjuvant therapy in post-menopausal women with estrogen receptor positive breast cancer. The drug is also used in treatment of metastatic endometrial cancer and endometrial sarcoma.

Meanwhile, reports said, pharmacies at Tata Memorial Hospital in Parel, Mumbai, continued to sell Novartis's branded medicine Sandostatin LAR (in 20 mg vial) for injection at Rs48,296, after a discount of 26 per cent against the Rs32,000 charged by chemists outside - that's less than 50 per cent of the printed MRP and 34 per cent less than the TMH pharmacy prices.

Variants of Octreotide, sold by Novartis under the brand Sandostatin LAR in 20 mg vial (injection) carries a maximum retail price (MRP) of Rs65,499.

Obviously, the institute did not take timely action despite having knowledge about downward price revision since January 2014, resulting in huge cost to patients for buying the drug from TMH pharmacies when the same was available with chemists in the hospital's vicinity at less than half the cost.

The National Pharmaceutical Pricing Authority (NPPA) proposes to bring several drugs in the oncology segment under the National List of Essential Medicines (NLEM) in the forthcoming revision of the NLEM being undertaken by the union health ministry to bring these costly drugs within the reach of common people.

The drugs recommended to be added to the NLEM include All Trans Retinoic Acid (ATRA), which is used for the treatment of acute promyelocytic leukaemia (APL); Non-Hodgkins lymphoma (NHL) drug Bendamustine; Rituximab, a monoclonal antibody against CD 20 antigen; Lenalidomide, an immunomodulatory and antiangiogenic drug, which is being used in wide range of cancers like multiple myeloma; breast cancer drug Trastuzumab; Capecitabine, which is indicated in gastrointestinal cancers, including stomach and colorectal cancers; Temozolomide (TMZ), a novel alkylating agent used in the management of malignant gliomas; Irinotecan, a camptothecin derivative used in various cancers such as colorectal, gliomas, glioblastomas, esophageal, stomach, cervical, ovarian, lung and mesothelioma; and Lung cancer drug Erlotinib.

India has over 2 million registered cancer patients with another million added each year while nearly 7,00,000 die each year due to the disease. Several cases go undetected. Experts say the incidence of cancer could rise five-fold by 2025.