Section:GDN 1N PaGe:5 Edition Date:190812 Edition:01 Zone: Sent at 11/8/2019 19:20 cYanmaGentaYellowbl
Monday 12 Aug ust 2019 The Guardian •
Bourne again 5
Romeo and Juliet win
with a touch of Grease
Page 10‘What’s my balance?’
NatWest to trial
voice-only banking
Page 15Firm’s profi t from cystic fi brosis
drug s predicted to hit $21bn
Sarah Boseley
Health editorA US company that is refusing to drop
its price for the life-changing cystic
fibrosis drug Orkambi to make it
aff ordable to NHS England is set to
make $21bn (£17.5bn) in profi t from
sales of both th e medicine and a sis-
ter formula, according to research.
Orkambi, made by Vertex, has a list
price of £104,000 per patient per year
but is not a cure. The National Institute
of Health and Care Excellence (Nice) in
England has said it is not cost eff ective.
Today , the Scottish Medicines Consor-
tium will decide whether to approve
the drug north of the border.
Parents in England have fought
for children with cystic fi brosis to be
allowed Orkambi for more than three
years since it was licensed.
Vertex claims it has invested billions
in research, has made a loss and needsa price that will allow it to invest in
future drugs for the disease.
But research by Aidan Hollis , a
professor of economics at Calgary
University in Canada, disputes that.
He estimated that Vertex would make
$21.1b n in profi t over the lifetimes of
Orkambi and an earlier drug called
Kalydeco, which is available on the
NHS but treats only a small propor-
tion of patients.
Early funding for research into the
two drugs came from a cystic fi brosis
foundation in the US , which received
a royalty on future profi ts. That was
bought by a company called Royalty
Pharma in 2013 for $3.3bn. In a paper
to be published in the journal Health-
care Policy , Hollis calculated that the
anticipated future profi ts at that time
were $33b n. Deducting Vertex’s costs,
he arrived at the fi gure of $21.1b n.
Vertex argues it has invested $11.8bn
in the research and development of
cystic fi brosis drugs since 2000.But Hollis said that investment was
a strategy for making more money. “ If
you choose to take your money and
reinvest it in something, it doesn’t
mean you didn’t make profi ts,” he said.
Vertex is working on a triple com-
bination drug, which includes two
medicines already on the market with
a third it is developing. The drugs at the
moment only work in a limited pro-
portion of cystic fi brosis cases, but
the triple is expected to benefi t 90%
of patients. Evaluate Pharma’s World
Preview 2019 last month predicted
that Vertex’s triple combination wouldmake more money than any other drug
for any condition in the pipeline today- $20bn over its lifetime.
Vertex’s fi nancial results for the sec-
ond quarter of 2019 showed product
revenues were up 25% from last year,
with a rise in expected revenue for the
whole year from $3.6bn to $3.7bn.
The cystic fi brosis drugs made by
Vertex are the fi rst that target the
underlying causes of the genetic
disease , which clogs children’s and
young adults’ lungs and shortens lives.
Rob Long, who has been buying
Orkambi privately for his nine-year-
old son, Aidan, said he was appalled by
the high prices. “It’s the obscene face
of capitalism, where a drug company
makes up its prices based on what it
thinks it can get away with,” he said.
NHS England said it was still in
negotiations with the company, which
it described as “an extreme outlier in
both pricing and behaviour”.
Vertex disagreed with Hollis’s
paper, saying that its research and
development costs between 2012
and 2017 represented 70% of its total
operating expenses. “ The price of our
medicines is based on the value they
bring and the diff erence they make to
patients’ lives, their families and soci-
eties, as well as the signifi cant R&D
investment we have made. ”
Femmes fatales Performers on Edinburgh’s Royal Mile promote the Philip Stokes play Heroin(e)
for Breakfast, in which the class A drug is personifi ed as a Marilyn Monroe-like character. The
award-winning play, which made its Edinburgh debut in 2009, has returned to the fringe this
year with a revamped and updated production. The Edinburgh festival runs until 26 August.PHOTOGRAPH:
LESLEY MARTINMenopausal
women in UK
facing severe
shortage of
HRT products
Amy WalkerA national shortage of hormone
replacement therapy (HRT) could
aff ect almost all menopausal women
in the UK.
Around half of the most commonly
prescribed HRT products, which
replace hormones including oestrogen
that naturally decline during meno-
pause, are out of stock.
According to the National Institute
for Health and Care Excellence, about
a million women in the UK use HRT.
The high street pharmacies Boots
and Lloyds are among those said to be
experiencing shortages.
The Department of Health and
Social Care said it was aware of sup-
ply issues caused by manufacturing
delays.
A spokes man said: “We are working
closely with all suppliers to maintain
overall fl ow of medicines to patients.
“Supplies of alternative HRT prod-
ucts are available and any patient
aff ected should discuss alternatives
with their doctor.”
The department became aware of
the problem in December but short-
ages have worsened in recent weeks.
Lloyds’ supplier, AAH Pharmaceu-
ticals, has run out of 15 of the 24 HRT
brands it stocks, according to fi gures
given to the Daily Mail.
The pharmaceutical retailer
Alliance, owned by the same group as
Boots, has run out of nine of 27 HRT
products.
Prof Helen Stokes-Lampard, chair of
the Royal College of GPs , said the real
reason for the shortages was unclear.
S he told BBC Radio 4’s PM pro-
gramme : “ We know that there are
the generic phrases like ‘supply issues’
and ‘manufacturing problems’. But
because it’s commercially sensitive ...
nobody will be honest with the pub-
lic and the NHS. So it’s frustrating.”
Stokes-Lampard encouraged
women to get repeat prescriptions
for the products earlier than usual. If
their pharmacies were out of stock ,
they should ask about alternatives and
inform their GP.
HRT is the most common form of
treatment for menopausal symptoms
including hot fl ushes, night sweats and
vaginal dryness. Products come as tab-
lets, skin patches, gels , vaginal creams,
pessaries and rings.27
The number of HRT products stocked
by the pharmaceutical retailer
Alliance. It has run out of nine‘Vertex makes up its
prices based on what
it can get away with’Rob Long
Father of a child patientliet win
f Grease
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