Lenalidomide, a lifesaving medicine to treat multiple myeloma (also known as Kahler’s disease) – a blood cancer of the plasma cells of bone marrow – has been included in the latest edition of the World Health Organisation’s (WHO) Essential Medicines List (EML).
This list acts as core guidance documents that helps countries prioritise critical health medications and is considered effective, essential and safe for a country’s health system.
In South Africa, more than 400 new cases of this type of cancer are reported annually, however, many cases are not reported to the National Cancer Registry, which makes the real number likely to be much higher than 400.
Cost of treatment
The current cost of lenalidomide in South Africa is a high R60 781 per patient per month and R729 372 for a full year’s course, which is depriving many patients of a chance at life, said Salomé Meyer from the Cancer Alliance in a press release by Fix the Patent Laws.
“The current high price charged for lenalidomide in South Africa means that government cannot afford to buy it – leaving no hope for people in need who rely on the public healthcare system.
“Medical schemes in the private sector are also unwilling to cover the full costs. This leaves the option for people to pay out of the pocket, or go without – it is your money or your life,” said Meyer.
India vs. South Africa
In India, a year’s course is sold at a fraction of the price by a generic supplier for R28 476. However, the government and its people are currently unable to buy more affordable generic versions from India, as the patent owning company, Celgene, holds 32 secondary patents on the medication and this could block generic competition until 2028.
The medicine is now no longer available in the public sector, which cares for 84% of the population, and patients in the private sector are struggling to pay the 20% co-payment. The important point is that studies on the cost of production of cancer medicines show that a substantial reduction in price is possible, and Lotti Rutter from Health GAP argues that keeping costs high only elevates pharmaceuticals’ monopoly.
“These unfair patents are simply to extend Celgene’s monopoly and keep prices high, and have been rejected in India and other countries. South Africa’s outdated patent laws are a critical factor driving the vast price difference on the same medicine,” she said.
“While we welcomed a final policy to reform these laws last year, we are still waiting for a bill from the government to move the process forward and actually ensure that people have improved access to medicines on the ground. Delays to this process are costing lives,” she added.
What is being done?
The Campaign for Access to Affordable Lenalidomide was launched in July in South Africa, and echoes the demands set out in a memorandum that was handed to the National Department of Health in April 2019. Some of the demands include:
- Provide affordable generic medicines, like lenalidomide, for cancer treatment in the public sector.
- Issue compulsory licenses in instances where patent barriers prevent the importation of more affordable versions of excessively priced cancer medicines.
- Ensure the efficient and transparent registration of medicines by the South African Health Products Regulation Agency (SAHPRA).
Part of the campaign’s action is urging Minister of Health, Dr Zweli Mkhize, to use his powers to grant a compulsory license that would allow for the importation of affordable lenalidomide. This opportunity, the Fix the Patent Laws campaign said, is a historic one for Dr Mkhize to save lives.
“We cannot allow more people to die without accessing a medicine that may save their lives simply because our government refuses to use the powers it has in law,” said Sibongile Tshabalala from the Treatment Action Campaign (TAC).
*Fix the Patent Laws is a campaign that advocates for the amendment of South African patent laws to prioritise public health.*