After battling advanced prostate cancer for a decade, Jim Larson said his doctor recommended he try a new treatment.
Pluvicto is the brand name for a treatment that kills cancer cells with the radioactive isotope lutetium-177.
Pharmaceutical company Novartis offers the treatment at $27,000 per dose — putting the average five-dose treatment at $135,000.
“I was all ready to go. We were excited,” he said. “But there’s no money now to pay for the drug from the government. And without that, it’s not going to go anywhere.”
Earlier this month, the pan-Canadian Pharmaceutical Alliance (pCPA) — which negotiates drug prices for provincial, territorial and federal public health plans — ended talks with Novartis, even though the Canadian Agency for Drugs and Technologies in Health recommends provinces cover Pluvicto treatments.
Now, hundreds of eligible patients will need to pay thousands of dollars to access the treatment. Larson is calling for pCPA and Novartis to get back to the table and for the federal government to cover Pluvicto for eligible patients.
“If this doesn’t happen within the next few months, we’re going to start to lose people,” he said. “People are going to die.”
A costly cancer treatment
According to the B.C. Cancer Agency, about 3,500 British Columbians are diagnosed with prostate cancer each year, and in 2021 alone, 705 people died from the disease.
Pluvicto is one of the few lutetium-177 cancer treatments approved in Canada.
The compound is injected intravenously and circulates around a patient’s body until it encounters a prostate cancer cell.
Then, it attaches itself to the cell before it disintegrates, emitting a beta particle which shreds DNA in the nucleus of the cancer cell — usually killing it.
Dr. Philip Cohen, a Metro Vancouver-based nuclear medicine researcher, said the treatment sometimes targets salivary glands and tear ducts, leaving patients with a dry mouth.
He said patients often show less severe side effects compared to chemotherapy, which can leave patients feeling nauseous and tired.
He said Pluvicto is one of about 20 new compounds reaching Canada’s drug approval process that aim to treat cancer in a similar way.
Mina Bechai, the CEO and Founder of Initio Medical, a private facility in Burnaby, B.C., where patients can access the treatment, said treatments like the lutetium-177 injection are promising.
“They have been very effective, but it all depends on the intervention time,” he said. “If you get into it too late, then you won’t really be able to help those patients.”
He said the treatment could help hundreds of cancer survivors, but the high cost prevents many patients from accessing Pluvicto.
“Patients have to self-fund their own treatment. That’s the sad part,” he said.
“We’ve got to do whatever we have to do to make options available.”
No coverage after negotiations end
Health Canada first approved Pluvicto in 2022.
In B.C., cancer treatments are covered through the B.C. Cancer Agency, which has no compassionate supply of Pluvicto.
A spokesperson for B.C. Cancer said after negotiations between the pCPA and Novartis collapsed, British Columbians would have to access the drug through third-party insurance or by paying for the treatment at a private facility.
Dominic Tan, acting pCPA CEO, said the alliance ended negotiations over the Pluvicto when it decided Novartis’s best offer for the cost of the drug was higher than the pCPA assessed it was worth.
“Despite a significant shift from the pCPA to compromise on price, during the many months of negotiation, the price gap for the drug remains too wide,” Tan said in an emailed statement.
“The pCPA has a responsibility to ensure that the price it negotiates for a drug is consistent with the evidence of its clinical benefit to patients and sustainable for the health system as a whole.”
Tan said the alliance was disappointed by the result of the negotiation and recognizes the decision may also disappoint the patients, families and caregivers who were awaiting its results. He said the pCPA is willing to head back to negotiations.
Meanwhile, a spokesperson for Novartis, said the company was also disappointed by the decision.
“We have heard from physicians, physician associations, and patient groups … who need options that will allow them not only to live longer but also preserve quality of life so they can continue to celebrate important milestones with loved ones,” a spokesperson said in an email.
Novartis said the average treatment is 4.54 doses.
A Fraser Valley man is calling for a new cancer treatment to be covered after the organization that represents public health plans ended negotiations with the company that makes the drug.
Each dose of Pluvicto must be made to order and requires a highly specialized manufacturing and distribution process to ensure each patient gets the right dose at the right time, which factors into the cost of the treatment, Novartis said.
It said it is prepared to pursue all available options to ensure eligible patients can access the treatment.
But that’s not enough for Larson. He’s calling for both sides to get back to the table and come to an agreement.
“Nobody wins when you walk away. Everybody loses. Get back to that table, Negotiate until you have a deal.”