NHIF and Janssen Pharmaceuticals in Kenya announce partnership to enhance patient access to prostate cancer drugs

By Francis Zyder

In Summary

• The Janssen Kenya Prostate cancer program will provide significant cost savings to NHIF members, and seeks to support efforts by NHIF to adopt new low cost service delivery models by embracing public-private partnerships (PPPs)
• NHIF two years ago introduced the cancer treatment reimbursement scheme for all its’ National Scheme members. The Scheme reimburses up-to a maximum of KES 600,000 a year for all cancers.
• NHIF is actively working to address barriers to cancer care access. With the Janssen Kenya Prostate cancer project, NHIF, has successfully managed to negotiate the price reduction of Zytiga from Kshs 200,000 to about Kshs 100,000.
• Janssen Pharmaceuticals is part of Johnson & Johnson, world´s largest and most broadly based healthcare company. Janssen envisions a world where cancer is a preventable, chronic or curable disease and is focused on developing solutions that prolong and improve patient lives to get there.
• Cancer is one of the major non-communicable diseases in Kenya and ranks third as a cause of death after infectious diseases and cardiovascular diseases
• Currently, the NHIF care package entails up to 10 chemotherapy sessions, oral and injectable anti-cancers drugs, inpatient and outpatient oncology services, 20 sessions for radio therapy, and up to two sessions for Brachytherapy for advanced cancer, per year

The National Hospital Insurance Fund (NHIF) in conjunction with Janssen, one of the pharmaceutical companies of Johnson & Johnson, has unveiled a joint partnership to enhance access of a crucial drug for local prostate cancer patients.

The Janssen Kenya Prostate cancer program will provide significant cost savings to NHIF members, and seeks to support efforts by NHIF to adopt new low cost service delivery models by embracing public-private partnerships (PPPs).

The partnership will see Janssen Pharmaceuticals, a specialist oncology pharmaceutical solutions provider, making one of its innovative medicines used for the treatment of advanced prostate cancer available at a subsidized rate for NHIF members.

The prescription drug, Zytiga (Abiraterone) will be available to NHIF members from selected public and private medical facilities. With the realization that Prostate cancer remains the leading cancer in men in Kenya, NHIF two years ago introduced the cancer treatment reimbursement scheme for all its’ National Scheme members. The Scheme reimburses up-to a maximum of KES 600,000 a year for all cancers. Last year, NHIF, spent Ksh 1.36 billion in the financial year 2017/ 2018 as payment towards oncology (cancer) treatments representing an 11% increase from the previous year.

Speaking at the launch of the joint partnership, Janssen Pharmaceuticals Director of Global Business Institutions and Patient insight, Global Market Access, Mr. Craig Winters, said the company is partnering with NHIF to enhance treatment of metastatic castrate resistant prostate cancer with Zytiga (Abiraterone) to facilitate a positive impact on the lives of patients with advanced prostate cancer.

The partnership, he said is geared at enhancing access for patients with advanced prostate cancer by getting more patients diagnosed and treated earlier while providing access to treatment with Zytiga (Abiraterone) through a Patient Assistance Program for prostate cancer patients who are also NHIF members.

The partnership with NHIF, Winter said will provide much needed financial relief as financing for cancer treatment remains a challenge for many developing countries including Kenya. In many developing countries, Cancer drugs remain out of reach for a majority of patients.

From a pharmaceutical standpoint, Winter, acknowledged that there is a high unmet need for treatment of metastatic castrate resistant prostate cancer. Novel hormonal therapy and chemotherapy are sequentially indicated for treatment of metastatic castrate resistant disease. One such novel antiandrogen is Zytiga (Abiraterone) that was developed by Janssen. Zytiga has proven efficacy and outcomes with extensive real world experience since its launch in 2011. Clinical data has shown significant extension of patient survival and maintenance of health related quality of life.

NHIF Claims and Benefits Manager Judy Otele said the insurance fund is actively working to address barriers to cancer care access. With the Janssen Kenya Prostate cancer project, NHIF, she disclosed has successfully managed to negotiate the price reduction of Zytiga from Kshs 200,000 to about Kshs 100,000.

“A lot however remains to be done to reduce the cost of cancer management and at NHIF we are asking healthcare providers to consider reviewing downwards the cost of radio therapy interventions,” Otele said, adding that, “There’s need to lobby all stakeholders including the government, investors, suppliers among others to make cancer care accessible and affordable through public-private partnerships.”

As part of the commitment, Janssen Kenya Country Manager Mr. Marseille Onyango, said the firm will make the treatment available at a discounted price for NHIF members as part of a corporate commitment to strengthen cancer care in sub-Sahara Africa.

“At Janssen Kenya, we are working hard to enhance access to our innovative medicines while leveraging partnerships and collaborations with key stakeholders such as NHIF to make a significant impact in the lives of cancer patients,” Onyango said and added, “Janssen is committed to support the national healthcare ideals as outlined in the Big Four Agenda. In recent years, Janssen has been actively providing support for awareness and capacity building initiatives geared at facilitating a speedy adoption of the National Cancer Control Strategy (NCCS) 2017-2022 by various stakeholders.”

Public Accounts Committee chairman Opiyo Wandayi who attended the partnership launch event described cancer as a crisis that will evolve to a calamity, if not addressed. The legislator pledged to provide support to ensure that initiatives such as the Janssen Kenya Prostate cancer project are devolved to grass root levels.

The Ministry of Health Head of Curative & Rehabilitative Services Dr. Izaq Odongo who represented Cabinet Secretary Cecily Kariuki, on his part confirmed that the government is focusing its efforts on strengthening health systems for Universal Health Coverage (UHC) as part of the National Cancer Control Strategy.

Janssen Pharmaceuticals is part of Johnson & Johnson, world´s largest and most broadly based healthcare company. Janssen envisions a world where cancer is a preventable, chronic or curable disease and is focused on developing solutions that prolong and improve patient lives to get there.

To ensure a coordinated response to cancer control in Kenya, the National Cancer Control Strategy (NCCS) 2017-2022 was developed to act as a framework to guide all stakeholders supporting cancer control in Kenya.

The strategy addresses the whole cancer ecosystem from prevention to survivorship and has 5 pillars namely: Prevention, Early Detection and Screening, Diagnosis, Registration and Surveillance, Treatment, Palliative Care and Survivorship, Coordination, Partnership and Financing and Monitoring, Evaluation and Research.

Cancer is one of the major non-communicable diseases in Kenya and ranks third as a cause of death after infectious diseases and cardiovascular diseases. It is estimated that there are 40,000 new cases annually and approximately 28,000 cancer related deaths every year. More than 70% of cancer cases are diagnosed at late stage when treatment outcomes are poor and palliative care is usually the only management amenable.

Currently, the NHIF care package entails up to 10 chemotherapy sessions, oral and injectable anti-cancers drugs, inpatient and outpatient oncology services, 20 sessions for radio therapy, and up to two sessions for Brachytherapy for advanced cancer, per year. Among the health facilities that offer the package include some level five and six hospitals, and selected private hospitals in urban centres.

NHIF covers six sessions for the first line treatment for up to Ksh25,000 per session, four sessions for the second and third line treatment for up to Ksh150,000 per session and 20 sessions of radiotherapy at Ksh3,600 per session. Biopsy is covered under the surgical package. Radiology is also done during the diagnosis stage, and this includes MRIs, ultrasounds, or CT scan and PET scan, also covered by NHIF.