So here’s one way to build market share - J&J’s Janssen-Cilag unit is offering to the UK’s National Health Service to cover the cost of a cancer med if a patient fails to show adequate process, The Financial Times reports.

The NHS would only pay for the new drug, Velcade, when patients responded well to it, under a joint proposal from Janssen-Cilag, and the National Institute for Clinical Excellence, the body that recommends which treatments the NHS should adopt.

The proposal is believed to be the first of its kind and could set a precedent that would help the NHS afford expensive new cancer treatments that can cost more than $20,000 a patient. The potential deal has added significance because it was the drugmaker that proposed the risk-sharing scheme to Nice, rather than the other way round.

Andrew Dillon, Nice chief executive, says: “It is too soon to say whether this could be the start of a trend. But there are certainly signs from our conversations with other companies that they are thinking along the same lines.”

However, the drugmaker and Nice are in fierce disagreement over exactly what level of improvement would be needed in patients taking the drug to trigger the moment when the NHS would start to pay.

Velcade is the first new treatment in a decade for the blood cancer multiple myeloma, which affects about 4,000 new patients a year in the UK. The drug does not cure the disease but, according to its manufacturer, it can prolong some patients’ lives by up to 2½ years,. A full course of eight 21-day cycles of treatment costs about £25,000.

Nice’s initial assessment was that, given the proportion of patients who respond, the treatment was too expensive to be cost-effective. Janssen-Cilag appealed. In doing so it proposed that the NHS should only pay for patients when a particular serum protein showed a better than 25 per cent reduction after four cycles of treatment – a cost of about £12,000.

Nice has backed the principle but has said that, to make the drug cost-effective, the NHS should pay only when the response rate is better than 50 per cent. The company said yesterday it was pleased Nice had backed the scheme but was alarmed at the higher threshold for payment that Nice had set.

Source: The Financial Times