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Dublin: 11 °C Wednesday 19 June, 2013

Minister will approve skin cancer ‘wonder drug’ when reimbursement deal is agreed

The Taoiseach says James Reilly is in talks to have Ipilimumab made available in Ireland, but only when its costs are reimbursible.

Ipilimumab - marked as Yervoy by its makers - is thought to be the most effective drug yet in the treatment of melanoma (pictured).
Ipilimumab - marked as Yervoy by its makers - is thought to be the most effective drug yet in the treatment of melanoma (pictured).
Image: Pulmonary Pathology via Flickr

THE TAOISEACH has said Ireland will approve the skin cancer ‘wonder drug’ Ipilimumab for use in Ireland, as soon as an arrangement can be reached in order to allow its costs to be reimbursable.

The drug, which is thought to be twice as effective as other drugs in treating melanoma, has been cleared by the European Medicines Agency but has not yet been made available to patients in Ireland.

This morning in the Dáil, Enda Kenny said the minister for health James Reilly was currently in negotiations with the makers of the drug in order to secure a deal where the drug could be available in Ireland with the costs to reimbursable.

Kenny said a course of treatment under the drug would cost in the region of €85,000, a cost the State was keen to address.

His comments came after Fianna Fáil leader Micheál Martin inquired why the drug was not yet available in Ireland, but was available to patients in the UK and the Netherlands.

“We are good at facilitating breakthrough drugs in cardiology and oncology,” Martin said. “It’s been one of our pluses, and one of our strengths.”

“Patients have been denied access to this treatment for too long.”

Kenny responded by insisting there had been no “deliberate hold-up” in the approval of the drug, and that he was “aware of the interest, particularly from those who have had people suffer as a consequence of this”.

“We want to be clearly understood that this country will continue to be at the forefront in the use of breakthrough drugs,” he said.

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Comments (36 Comments)

  • Kim 02/05/12 #

    My Dad was on the drugs trial for this drug, in Ireland. His cancer had already progressed, and he unfortunately passed away shortly after, but this drug is incredible in early diagnosis. Enda thinks 85,000 is too much to save a life, but is willing to give 85 billion to the banks, sums up this country.

    Reply
  • franco 02/05/12 #

    get over the red tape mr reilly and help these people they are dying in front of you they dont have the luxury of time….

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    • My 36 yearl old friend died last month from melanoma, had this drug been available she would still be here with her 9 year old son and he would not be an orphan. Its disgraceful that this drug has been witheld when people are fighting for their lives.

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    • Ann
      I am so sorry for your loss , and of course her family’s too. So sad that her death could have been prevented. !
      The real fact of delaying treatment like this can not be ignored .

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  • Stop talking about it and start saving lives, melanoma kills and ?85k is a small price for a life. Not everybody has the luxury of time to wait so for once make a decision now that proves you’re worthy of the job Mr Reilly.

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  • This has really got my blood boiling! People are going to die because of two completely incompetent fools! How low are they prepared to go? Money hard working people are contributing to PRSI and USC is being diverted to pay wealthy, gambling bond holders. This is absolutely scandalous. We have to get this crowd of bastards out now!

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  • Stop the sunblock???? Great idea!!!

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  • We need to be realistic about how effective this drug really is before we jump to conclusions. This drug is not a cure for melanoma, although it is more effective than any other available treatment. It is only for use in advanced melanoma, it is not a treatment that would be started early in the progression of the disease. In trials, it was found to extend average (median) life expectancy compared to the primary treatment for advanced melanoma by about 4 months. Of the people in a trial who were given treatment with Yervoy, less than half survived for one year. However, this compared to just a quarter of those who received the alternative treatment.

    I’m not expressing an opinion on whether the HSE should fund this drug or not, but just rather pointing out that in the melee of comment, the actual facts about the drug itself can become lost.

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  • Reilly Minister for health is a pure disaster he Is closing down units ,A&E’s, over-crowding other facilities because of No Forward Planning.But do this one thing Minister Reilly and give people a chance at life.Time is if the essence.We expected greater progress from one such as you with your Qualifications,but we have been so let down and I feel you are not capable if the Ministry you have been entrusted with, so either you start showing progress or resign Time is not there for the patients that need this treatment so please do not waste time and start saving precious lives

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  • mmmmm……..

    know someone close who got it a over a year ago and it had absolutely zero effect on the melanoma. since passed away. not sure it’s the ‘wonder’ drug it’s made out to be. we seem to be only hearing the success ‘s. having said that, everyone should get to try it. I wonder if some Indian or Asian pharmaceutical will produce a generic brand and sell it at 100th of the cost.

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  • Yeah???? Show me your research !

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  • This is no wonder drug, it comes with some very serious, potentially fatal side effects. If I had no other option I may well avail of it but even then I would think long and hard about it first. I don’t like how the media constantly raise people’s expectations about medical breakthroughs. Yes there are medial advances however this is a slow and laborious process against a backdrop of continual public funding cuts. Industry are great at talking a good game but when it comes to the crunch they are all about making money not delivering efficacious cost effective healthcare.

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    • I accept your intentions “Gay Pea” but it remains true that medical science provides so few possible treatments that can extend the life of someone diagnosed with malignant melanoma. Malignant Melanoma has a fatal direct effect so side effects, including fatal ones are seen by sufferers as worth the risk when their outcomes are potentially worse. Hope is often the life-force for a cancer-sufferer so even the chance of a “wonder-drug” keeps hope alive.

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    • I make this comment more for the benefit of people who may feel panicked because they do not have access to it. I understand how these drugs work, more than the majority of oncologists, I can promise you that. These are very powerful molecules that play that have unpredictable effects that vary from person to person based on a multitude of factors. The clinical trial data in no way suggests this is a wonder drug, so let’s not let the drug company executives and their “clinical champions” suggest otherwise. It may buy people some months of life but at what cost physically? I understand when people are dying they look for whatever hope is out there, which is why I object to private companies developing and marketing drugs. It’s better not to bullshit people, I don’t peddle false hope, I think it’s much less cruel that than talking about wonder drugs that may be no more wonderful than less expensive therapeutics already out there. People need to educate themselves in these matters so they’re not being manipulated by pharma marketing departments to rush through regulatory approval, to keep a share prices high. I’m sorry if that sounds cynical, but experience has made me so.

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    • Sorry “Gay Pea” your mask may have slipped a little. What exactly are your qualifications in relation to malignant melanoma? What you have just stated suggests that you actually don’t know anything about that form of cancer. Prove me wrong or apologise for commenting out of pure ignorance of the treatment of malignant melanoma. Please don’t fudge this, if you genuinely know what you are talking about, state your specific knowledge about malignant melanoma. Now.

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    • I’m making a serious point from a professional position, if you just wish to be insulting about it then I’ve no interest in perusing a discussion with you – we’ve all lost people to cancers of various cell types so none of us have a monopoly on suffering. Goodnight .

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    • Good one “Gay Pea”. First you know more than “most oncologists” and now say you have a “professional opinion” that you have no interest in “perusing a discussion” with me. You are a disgrace for trolling on a discussion about a serious topic and crapping on about stuff you know nothing about. You claimed to know detailed information about the effectiveness about a specific melanoma drug and it is clear that you don’t have any actual knowledge of the drug in question and just want to have a cut at pharmaceutical companies in general, regardless of the human issues involved. Shame on you, if you have any shame. Never talk the talk until you can walk the walk.

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  • 85k for any drug is too much, when will governments and health insurance companies stand up to the pharma companies and get some realistic prices

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    • Along with Andrew Telford below, thank you for some common sense. It would be great if the health service had an unlimited budget and every drug an individual wanted, but that simply isn’t the case. I spoke with my aunt who had cancer and does fundraising the other night, and she felt the same way saying she doubted it cost €85,000 to make the drug. If the government can save maybe €20,000 per person on it, that adds up to millions a year less spent on this particular drug which can be used to buy other drugs.

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    • I really hope it stays fine for you so you get to keep your smug economist angle on this. If you ever had malignant melanoma you would understand what a horrible form of cancer it is. Normal cancer treatments are mostly useless and the prognosis for a patient is usually very obvious from the pathology on the initial tumour. Melanoma is different and any possibility of survival would be grabbed by any sufferer.

      I agree about the government needing to sort out the issue of cost, but not AFTER people have died. There must be some mechanism where a drug is made available on a pilot basis until there is agreement on the final cost. Your prism is obviously a rose-tinted one and you would really need to wake up and put yourself in the shoes of someone staring death in the face before your pronounce on such matters.

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    • Well said. A valid point. While the government’s galling financial decisions are frustrating – to put it mildly – it must also be acknowledged that pharma derives enormous profits from some of these medicines and it often seems like the more life-threatening the illness, the more zeroes pop up on the price tag.

      I don’t agree with Reilly withholding medicines purely because of cost, especially when each one of us is having to dig deeper and deeper into emptier pockets for unsecured bondholders, but let’s also be clear that these companies set the price. They’re not beholden to the IMF and the ECB. Or Merkel. Sarkozy. Geithner.
      You’d think with our fairly handy corporate tax rate that they’d do us a favour. €85,000 per course of treatment? I’d do anything for a loved one, of course. But it’s utterly exploitative.

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    • @B Collins, on a patient level, needing to stay alive, the arguments about money rate bottom to everything else. But maybe subjective thinking like that shouldn’t be used to make decisions about important amounts of money and people’s lives. But are objective reasons any better? Does our recent history as a nation show that objective decisions about money have been sound decisions and have resulted in sound social outcomes?

      Or maybe decisions dealing with the plight of people dealing with various potentially fatal diseases are necessarily subjective? Maybe that is the way it should be. Live or die? How much? Live a bit longer? How much? Have a better quality of life? How much? Be healthier? How much? Those questions traverse the full range of human experience and I believe that money cannot be the deciding factor in any of them. If it can be, we can legitimately excuse anything.

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  • And if that €85k was instead used to pay a doctors yearly salary who saved 20 lives in that time…

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  • my drs never told me sunblock caused skin cancer after i was diagnosed with stage 1 malignant melanoma! somehow if it were true i don’t think they wud have told me to wear factor 50!

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  • You don’t get skin cancer only from burning the ass of yourself , your open to it every day you step outside, thats why we should wear sunblock all year round not just on holidays or our two weeks of summer each year. I lost my mother to skin cancer, she never sat in the sun, it was a combination of being a smoker, (even though she had quit ten years earlier ) and being out and about.

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    • Sun block CAUSES cancer. I suggest you do some research!

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    • Most of the research on sunscreen fails to establish a statistically significant causal relationship between sunscreen use and melanoma, although incidence does appear higher in some studies.

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    • What the research actually suggests is that moderate sensible exposure to sunshine actually increases the immune systems ability to eliminate malignant cells by stimulating the production of important anti cancer immune cells. The big problem is binging, so the fortnight on a beach Southern Spain after a bleak Irish winter is an issue, likewise people who allow themselves to go lobster red every time the sun comes out are high risk, particularly fair skinned Irish people. The natural cellular defenses become overwhelmed in these situations not having been primed to cope with this kind of UV onslaught – that’s where the problems occur.

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  • good people are dying because of this delay, if they just cut their wages a little and their expenses this would help pay for it. I think most decent people in Ireland would happily take a hit to pay for these poor unfortunates. If every working person and person on the dole took a hit of just 50 cent a week that would generate roughly €1142000 which im sure could pay for this drug for a considerable amount of people. Thats a rough estimate give or take a few grand obviously.

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  • Would you bet your life on that? I mean really? Try to imagine yourself having been diagnosed with malignant melanoma. Imagine the specialist spelling out your chances. Then talk about the money,

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  • II have a scar on my right cheek from a large mole removed when I was three years old. It was itchy and the bumpy red part bled when scratched. Turns out it was Basal Cell Carcinoma.

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  • If you don’t want skin cancer, then stop lathering sunblock all over yourselves and be sensible about how much time you spend in the sun.

    Reply

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