We do not understand why the Decision-Making Forum for new methods has such a low willingness to pay to approve the breast cancer drug Trodelvy. It is embarrassing and painful to see that the Decision Forum comes up with a price proposal that is so low that the other party does not even want to consider it. Once again, we feel that the Decision Forum believes that the lives of many of our members are not worth much. Once again, they have refused the introduction of Trodelvy. This is a treatment that will give breast cancer patients with incurable breast cancer some extra time with their loved ones, and give them the opportunity to live longer with a better quality of life. Once again, we are furious at a system that does not work in the best interests of patients. When assessing whether medicinal products should be paid for by the public sector, there are some criteria that are the basis. 1. Health gain (utility) 2. Costs (resources) 3. Severity of the disease (willingness to pay). Is the medicine cost-effective, does it provide value for money? Can society afford it, and is it budget-efficient? Decision-making forums conclude in far too many cases that the effect of the medicines is not in a reasonable relationship to the price. Why is the willingness to pay in Norway lower than in other comparable countries? If you look at the overview of gross national income for 2021, Norway is in 3rd place, while for example Germany is in 11th place. Nevertheless, the proportion of available medicines covered by the public health system is 87 per cent in Germany, while the corresponding figure for Norway is 45 per cent. Then the arguments of the Decision Forum that the drugs are too expensive and that we cannot afford to introduce the drugs do not make sense. Then it’s about the willingness to pay, and we at the Breast Cancer Association find that shocking and reprehensible. In order for breast cancer patients to receive the best possible and correct treatment, we depend on research, and research costs money. We depend on the pharmaceutical industry constantly researching and developing new treatments. We must be willing to pay for that. Progress costs. Of course, we depend on the pharmaceutical industry not to overprice itself and to be willing to negotiate on price, but it is embarrassing that Beslutningsforum makes a counteroffer in price negotiations that is so low that the supplier will not even consider it. Decision Forum itself says that Trodelvy is a medicine they would like to offer to patients in Norway. But again, they believe that the price is too high compared to the documented benefits. Studies document better survival and a better quality of life among those who have received treatment, and the professional community in Norway says that it is regrettable that they cannot offer Trodelvy to women who have triple negative breast cancer with spread. Triple negative breast cancer often affects younger women. Mothers of young children who need to be as fit as possible and present as long as possible for their children. These women have a poor prognosis and new treatments and new treatment principles are needed. Trodelvy really represents an advance in the treatment of this patient group. The problem is not only willingness to pay, but there are also major challenges in terms of time spent in introducing new medicines and treatments. A recently published report shows that Norway takes an average of 443 days from when a drug is EU-approved until it is introduced into the public health service. This is much longer than neighboring countries such as Denmark, Sweden and Finland, which use an average of 191 days, 320 days and 329 days respectively. One of the many drugs affected by the sluggishness of the system is Keytruda. Keytruda is a treatment option that can reduce the risk of recurrence in those with triple negative breast cancer. It took almost 11 months for Keyutruda to even get a case manager at the Norwegian Medicines Agency. The system has set a maximum limit that a case manager must be assigned within 6 months. Unfortunately, there are many examples of medicines that get stuck in the system due to long use or are considered too ineffective in relation to the price. Among other things, Verzenios, a drug to prevent the recurrence of breast cancer, has been rejected due to price. How can it be defended that the system is unable to meet its own deadlines? Why must patients who are waiting for vital drugs, which Beslutningsforum would also like to offer, not be allowed to use these because they are considered to be too expensive? The Breast Cancer Association believes that it is high time that new priorities are established for the introduction of medicines, that the system is changed so that the processing time is reduced considerably and that the willingness to pay for vital and life-extending medicines increases.
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Progress costs – Speech
