NHIF strikes deal to buy cancer drug at half price

Prostate cancer patients are set to access a crucial drug used to manage the condition after the National Hospital Insurance Fund unveiled a partnership with the manufacturer.

Under the partnership, Janssen, a pharmaceutical company affiliated with Johnson & Johnson, will provide drug to NHIF members at a subsidised cost.
Prostate cancer develops in the prostate gland located at the base of the bladder, when prostate cells multiply abnormally and uncontrollably.

Tumour cells use testosterone for growth. The hormone is made by the testicles and adrenal glands, but in men with advanced prostate cancer (which has spread to other parts of the body -- called metastatic cancer), the tumours also produce testosterone.

Treatment seeks to decrease hormone production, but some therapies only decrease hormone production in the testicles, but not in the adrenal glands or in the tumour.

Abiraterone acetate was developed to reduce hormone production beyond the testicles, which slows the growth of the tumour or shrinks it.

The once-a-day pill therapy approved in 2011, is usually prescribed for men who are resistant to standard hormonal therapy, and whose cancer has spread to other parts of the body. This is known as metastatic castration-resistant prostate cancer. Patients have usually also had chemotherapy using docetaxel.

The drug is taken with the steroid prednisone to reduce side effects such as high blood pressure, low levels of potassium and fluid retention.

COST OF CANCER MANAGEMENT

Abiraterone acetate (brand name Zytiga) will be available to NHIF members from select public and private medical facilities. According to NHIF Claims and Benefits Manager Judith Otele the fund will buy the drugs at Sh100,000 instead of Sh200,000, for a one-month dose.

“However, a lot remains to be done to reduce the cost of cancer management. We are asking healthcare providers to review the cost of radiotherapy,” added Ms Otele, noting that joint efforts are needed to make cancer care accessible and affordable to all patients.

“The partnership (Janssen Kenya Prostate Cancer Programme) is geared at enhancing access for patients with advanced prostate cancer by getting more patients diagnosed and treated earlier, while providing access to treatment with Zytiga through a patient assistance programme for NHIF members,” said Janssen Pharmaceuticals Director of Global Business Institutions and Patient insight Craig Winters, during the launch.

Mr Winters added that there is a high unmet need for treatment of advanced prostate cancer, and the arrangement would provide “much needed financial relief for patients since payment for cancer treatment remains a challenge for many.”

NHIF covers diagnosis – biopsy, MRI, ultrasound, CT scan and PET scan – and reimburses up to a maximum of Sh600,000 a year for treatment of all cancers. This would mean that accounting for drugs alone, the limit for the prostate cancer patient would run out in six months.

NHIF’s cancer package covers up to 10 chemotherapy sessions, oral and injectable anti-cancer drugs, inpatient and outpatient oncology services, 20 radiotherapy sessions and up to two sessions of brachytherapy for advanced cancer, per year.

NHIF covers six sessions for first-line treatment for up to Sh25,000 per session, four sessions for the second and third line treatment for up to Sh150,000 per session and 20 sessions of radiotherapy at Sh3,600 per session.

Last year, NHIF spent Sh1.36 billion on cancer treatments, an 11 per cent increase from the previous year.

Cancer, a non-communicable disease, is the third leading cause of death in Kenya, with the World Health Organisation estimating that there are 40,000 new cases and 28,000 cancer-related deaths every year.

Prostate cancer is the fourth commonest cancer in Kenya, accounting for six per cent of cancer cases and 15 per cent of new cancer cases in men. It is the fifth leading cause of cancer death among Kenyans.

The government recommends individualised screening, and recommends screening for men above the age of 40, who have a family history of prostate cancer or who have tell-tale signs.