The Department of Health has persuaded pharmaceutical company Roche to halve the price of its cancer drug rituximab, opening the way for the government to provide it to more patients. The drug belongs to an expensive class of medicines called biologics, and is used for treating non-Hodgkin's lymphoma, leukaemia, and severe rheumatoid arthritis.
Branded MabThera by Roche, the drug has until now been too expensive for the state to procure on a wide scale, the department's deputy director-general for health regulation and compliance, Anban Pillay, said on Monday.
The fact that it is on the national tender means provinces with the capacity to offer cancer treatment will purchase the drug, within the constraints of their budgets. The main cancer treatment centres are in Gauteng, KwaZulu-Natal, the Western Cape and the Free State.
Roche is a price-setter for MabThera, as the only market with a rival product is India. The drug generated $1,52bn in revenue for Roche during the third quarter of last year.
However, its market dominance may face a challenge in the near future, as Hyderabad-based Dr Reddy's has previously said it will market its version of the drug - branded Reditux - beyond India's borders once the patent on rituximab expires in the US in 2015. Other generic companies including Cipla and Ranbaxy are also developing capacity to make biologics.
The department's latest two-year oncology tender, on its website, shows the government is willing to pay R7950 for a 50ml vial of the injectable rituximab, and R1590 for a 10ml vial.
Dr Pillay said the health department was also in discussion with Roche over the scope for a "more affordable" price for its breast cancer drug Herceptin, which was too expensive.
Herceptin is available only to state patients who are enrolled in clinical trials, and to people who belong to medical schemes willing to pay for it.
Medical schemes vary in the extent to which they will foot the bill; some schemes pay for a year's treatment, while others will pay for only nine weeks.
Until this year, some breast cancer patients in KwaZulu-Natal were able to get Herceptin at government hospitals on a limited basis, according to clinical oncologist Poovan Govender.
Doctors had been able to motivate for Herceptin on a patient-by-patient basis, but the budget constraints facing the province meant this was no longer possible, he said.
Dr Pillay said some biologics that were unaffordable to the state - such as Novartis's leukaemia drug Gleevec - were available at no charge to some public sector patients through what are known as "patient access" programmes, where the drugs are donated by the company.
However, these programmes were not open to private sector patients, as they breached the medicine pricing laws, which say there must be a uniform price for the private market.
Roche had not responded to a request for comment at the time of going to press.
"We would like to see that oncology is managed from a national point of view, and that everyone gets access to the same treatment everywhere," said Linda Greff from the advocacy group, Cancer Alliance.