Definitely, the access of the French to drugs does not stop making people cough. While the government is working on a new roadmap intended to stem the surge in shortages of old essential drugs in pharmacies and hospitals, another controversy has been swirling for several months on patients’ access to innovative treatments. In question, a series of opinions unfavorable to a care given by the High Authority for Health (HAS).
At the beginning of January, Keytruda (MSD), the best-selling cancer drug in the world, was thus challenged in the treatment of a rare endometrial cancer. A month later, Retsevmo (Lilly), a candidate for reimbursement for first-line treatment of advanced lung cancer, was also rejected. At the end of March, it was the turn of Brukinsa (BeiGene), prescribed for patients with Waldenström macroglobulinemia, an uncommon blood cancer, to be rejected.
These drugs had yet been approved for marketing by the European Medicines Agency. Authorized in November 2021 by the European Union, Brukinsa is, for example, already available and reimbursed in fifteen countries of the Old Continent. But for lack of the green light from the tricolor health authority, French patients will not benefit from it. Or at least not right away. “Research and administrative time are not the patient’s time, for which every minute lost can be vital”, explains David Fiant, president of Vaincre la mucoviscidose. Alongside the Grégory Lemarchal association, he fought for many months to make Kaftrio (Vertex) treatment available as quickly as possible to the greatest number of patients.
If the refusals of the HAS are not rare – their proportion has been stable in recent years, ensures the health authority – they have aroused an outcry in recent months among certain learned societies and patient associations. At the end of January, the French Society for Predictive and Personalized Medicine launched hostilities, expressing indignation at the “repeated negative reviews”rendered in particular for targeted therapy medicinal products in oncology, “which raise the question of the loss of opportunity for French patients”.
“Medical service rendered”
In a grandstand at Worldthe president of the French association of patients with multiple myeloma regretted, for his part, “deleterious arbitrations”. Nearly 150 oncologists co-signed a letter challenging Emmanuel Macron. Under fire from the critics, the HAS responded by emphasizing the need “scientific rigor” who should preside over any evaluation, she called for “Do not confuse speed with haste, effective progress with novelty of interest not yet demonstrated”.
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