by Xinhua writer Wang Zichen
BRUSSELS, July 20 (Xinhua) -- Novartis, the European pharmaceutical giant, was praised by U.S. President Donald Trump on Thursday after deciding against raising drug prices.
But leading doctors said that Gleevec, one of Novartis's major products that treats chronic myeloid leukemia (CML), had already been too expensive to be affordable.
"Thank you to Novartis for not increasing your prices on prescription drugs... We are making a big push to actually reduce the prices, maybe substantially, on prescription drugs," Trump tweeted.
The tweet came after Novartis' decision was well-reported on Wednesday. Though based in Europe, the company apparently felt U.S. pressure against the pharmaceutical industry.
"When I looked at the policy environment with our team in the U.S., we see this dynamic environment (and) we thought the prudent thing to do was to pull back on any further price increase in 2018," Novartis CEO Vas Narasimhan told Bloomberg TV.
Pharmaceutical companies have for years been under pressure over the pricing of their drugs, and one of the most high-profile cases is Novartis' Gleevec, a miracle drug dubbed a breakthrough in cancer treatment for CML.
Gleevec, approved by the U.S. Food and Drug Administration in 2001, has been enormously profitable for Novartis.
Its sales were 4.7 billion U.S. dollars in 2012, making it Novartis' then best-selling drug. In 2017, sales were 1.9 billion, ranking it Novartis' No. 3 drug.
Behind the huge sales, the price of Gleevec - and others - became so high that in 2013 more than 100 cancer doctors from across the world took the unusual step of signing a commentary to ask leading pharmaceutical companies to make the drugs more affordable.
The commentary published in Blood, the journal of the American Society of Hematology, noted that "Initially priced at nearly 30,000 U.S. dollars per year when it was released in 2001, its price has now increased to 92,000 U.S. dollars in 2012, despite the fact that all research costs were accounted for in the original proposed price."
How about its price five years later? "Very high and keeps going higher. 146,000+ U.S. dollars in 2017. This is not affordable to patients," Dr. Hagop Kantarjian, chair of the Department of Leukemia at The University of Texas MD Anderson Cancer Center in the United States, told Xinhua in an email.
The commentary proposed to begin a dialogue "to address the reasons behind high cancer drug prices and offer solutions to reduce them."
Novartis said in a statement at the time, as quoted in The New York Times, that "We recognize that sustainability of health care systems is a complex topic and we welcome the opportunity to be part of the dialogue."
"Nothing happened. Drug companies do not want any dialogue or reasonable solutions," said Kantarjian, who led the effort to publish the commentary.
"Not much has changed in five years. Despite several generic versions of Gleevec reaching the market, the price remains quite high and solutions are quite difficult," Dr. Brian J. Druker, who was awarded the eminent Lasker-DeBakey Clinical Medical Research Award in 2009 for his contribution to the development of Gleevec and signed the commentary, told Xinhua in an email.
A spokeswoman of Novartis, when contacted by Xinhua, said the company "puts the health and safety of patients as top priority, and is committed to researching, developing and manufacturing the innovative medicine to meet patients' needs."
The spokeswoman also pointed to the Novartis-sponsored Glivec Patient Assistance Program (GIPAP), which served the CML treatment needs of approximately 75,000 people by September 2017.
AT WHAT COST?
One of the key problems behind the high prices is that "it is incredibly expensive to develop these medications and drug patents have a limited lifespan in which companies can recoup their investment," Druker said.
The Novartis spokeswoman also referred to third-party articles, saying an enormous amount of resources was required to develop a successful drug such as Gleevec, without elaborating its total cost.
However, despite the consensus that innovation and discoveries must be rewarded and pharmaceutical companies should benefit from healthy revenues, it remains an open question how high a drug is justifiably charged.
The cost for bringing a new cancer drug to market, including "the cost of development of the new (successful) drug and all other drugs that failed during development ... and ancillary expenses," ranges from as high as 1 billion U.S. dollars to as low as 60 to 90 million U.S. dollars, as estimated by the 2013 commentary.
"In other words, once a company sells about a billion dollars-worth of a drug, most of the rest is profit," the commentary added.
"If prices are too high, patients suffer. If prices are too low, companies go out of business and drug companies are the main source of medications such as this (Gleevec)," Druker told Xinhua.
"Coming up with a solution that balances these interests is quite difficult and I am not aware of one that has been proposed that would work," Druker added.