The Competition Commission is looking at three major global pharmaceutical companies operating in South Africa for alleged over-pricing of cancer medicines. In some cases the Commission highlighted there were no competitive drugs available on the market leaving consumers with no other choices. The companies under investigation include Roche Holding AG (Roche), Pfizer Inc. (Pfizer) and Aspen Pharmacare Holdings Ltd (Aspen).

“The Commission has identified the healthcare sector and in particular pharmaceuticals as a priority sector for its enforcement efforts due to the likely negative impact that anti-competitive conduct in that sector would have on consumers in general and specifically the poor and vulnerable,” said the Commissioner, Tembinkosi Bonakele.

The Fix the Patent Laws coalition welcomed the news saying it was a major victory in the struggle to ensure that all people in South Africa can access the medicines they need to stay healthy and survive.

Roche and its pricing of breast cancer treatment

In the case of Roche, the Commission has reason to believe that its US-based biotechnology firm, Genentech, have and continue to engage in excessive pricing, price discrimination and/or exclusionary conduct in the provision of breast cancer medicine in South Africa.

FTPL took the opportunity to highlight its Tobeka Daki Campaign for Access to trastuzumab, which was named after Tobeka Daki a cancer activist who died of breast cancer in November last year. “Even though Tobeka’s doctor thought she should be provided trastuzumab, Tobeka could never access the medicine due to its high price – over R500, 000 per treatment course in the private sector,” said the FTPL in a statement.

The Commission also pointed out that breast cancer treatment is unaffordable in South Africa and many medical schemes refuse to pay for treatment based on cost. One of the largest medical schemes in South Africa, Discovery Health, does however cover trastuzumab, except on its Key Care plans.  “A 12-month course of Herceptin in the private sector costs over R500, 000, or more if a higher dosage is required. As a result of exorbitant prices, most breast cancer patients in both the private and public sectors are unable to get treatment,” said the Commission.

Breast cancer is the leading form of cancer affecting women in South Africa and trastuzumab is an essential form of treatment for this type of cancer according to the World Health Organisation (WHO), as well as for some types of stomach cancer.

In South Africa, only Roche’s versions of trastuzumab are available and are sold under the names Herceptin and Herclon. Genentech provides exclusive marketing rights to Roche for this medication.

Back in February, Roche issued a statement saying it shared concerns regarding access to medicines such as trastuzumab. However, it argued that a collaborative approach was needed and that access to healthcare is a ‘shared responsibility and commitment’. The pharma pointed to collaborations it had forged with Kenya, Morocco and Madagascar.

Pfizer and lung cancer medication

It is suspected that Pfizer is charging excessively for its lung cancer medication in South Africa. It’s the only provider of lung cancer treatment medication known as xalkori crizotinib. The Commission said it has information that suggests lung cancer treatment is unaffordable in South Africa and medical schemes are refusing to pay for it.

According to the Commission, xalkori crizotinib costs around R152, 000 for 250g when bought from an agent, Equity Pty Ltd. “Further information suggests that there was a price reduction of R72, 000 per month for 250mg. This conduct is suggestive of abusive behaviour in respect of the supply of xalkori crizotinib in South Africa,” said the Commission.

Allegations against Aspen

The Commission is also snooping around Aspen which it claims has engaged in excessive pricing in certain cancer medications including Leukeran, which is chemotherapy medication used to treat chronic lymphocytic leukaemia, Hodgkin lymphoma and non-Hodgkin lymphoma; Alkeran used to treat myeloma and epithelial ovarian cancer and Myleran which is used in children and adults as a conditioning agent prior to bone marrow transplantation, especially in chronic myelogenous leukaemia, other forms of leukaemia, lymphomas and myeloproliferative disorders.

With regards to Myleran, Aspen is the only supplier of a generic version of busulfan in tablet form. “No active products containing the same active ingredient appears to have been registered by the Medicines Control Council (MCC),” said the Commission.

The Commission added that the three investigations have been prioritised and that all relevant resources were in place to ensure that the investigation was concluded soonest. The Democratic Alliance’s shadow minister of health, Patricia Kopane said she welcomed the decision to investigate the overpricing allegations but said the opposition party would want to wait until the Commission had finalised its investigation and issued a report before it would comment.