§ Mr. Carter-Jonesasked the Secretary of State for Social Services (1) what is the annual cost to the National Health Service of treating a transplant heart patient with cyclosporin; what is the average number of years for which such treatment is required; and if he will make a statement;
(2) what is the annual cost to the National Health Service of treating a transplant pancreas patient with cyclosporin; what is the average number of years for which such treatment is required; and if he will make a statement;
410W(3) what is the annual cost to the National Health Service of treating a transplant liver patient with cyclosporin; what is the average number of years for which such treatment is required; and if he will make a statement;
(4) what is the annual cost to the National Health Service of treating a kidney transplant patient with cyclosporin; what is the average number of years for which such treatment is required; and if he will make a statement.
§ Mr. Kenneth ClarkeThe average duration of treatment with cyclosporin of patients who have received an organ transplant, and the precise annual costs of such treatment, will be dependent on the individual clinical management of the patients concerned. We do not collect and record the detailed relevant information centrally. However, the costs of immunosuppressant treatment have tended to decline over recent years as a result of dosage reductions designed to minimise undesirable side effects. We now estimate that, where cyclosporin is used as the main immunosuppressive agent, the annual costs of treating an adult are in the region of £2,000, reckoned from a date six months after an organ transplant operation has been performed. The costs of immunosuppression are unlikely to vary significantly according to which organ has been transplanted.
§ Mr. Carter-Jonesasked the Secretary of State for Social Services what alternatives to the use of cyclosporin as a prophylaxis in the treatment of grafts and transplants have been assessed by the National Health Service and with what results.
§ Mr. Kenneth ClarkeConventional treatment for the prevention of graft rejection is with azathioprine and steroids, and trials are now being undertaken both in this country and elsewhere to assess the best way of using these drugs in combination with cyclosporin so as to maximise the benefit to patients, minimise side effects and reduce costs. Research is being conducted into the development of new immunosuppressive drugs, but we are not aware of any that are yet beyond the experimental stage. Because of high research costs and the relatively small demand for immunosuppressants, it is likely that the benefits of any new developments will be from an improvement in effectiveness and a reduction in side effects rather than from lower costs.
§ Mr. Carter-Jonesasked the Secretary of State for Social Services whether he has received any representations from medical or other authoritative persons about the cost to the National Health Service of the drug cyclosporin; and if he will make a statement.
§ Mr. Kenneth ClarkeWe received representations about the costs of cyclosporin in 1983 from the chairman of the British Transplantation Society and last year from the chairman of the Wessex regional health authority. In our discussions with the drug's manufacturer, Sandoz Products Limited, the company cited continuing high production costs as preventing the possibility of a price reduction but agreed not to increase the price during 1984. We do not control the initial pricing of drugs when launched but subsequent price changes are governed by the extent of the manufacturer's allowed profitability on sales of medicines to the National Health Service under the pharmaceutical price regulation scheme.
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§ Mr. Carter-Jonesasked the Secretary of State for Social Services what is the cost per unit dose of cyclosporin.
§ Mr. Kenneth ClarkeThe list price of cyclosporin is as follows:
Strength mg/ml Type Quantity Price £ 50 1 ml ampoule 10 16.24 50 5 ml ampoule 10 77.15 100 Oral solution 50 ml 1 105.00 Prices on contract to hospitals will be somewhat less.