The costs of new drugs to treat cancer (and other disorders)

In what is being described as “an extraordinary step” in some media reports, a group of more than 100 leukemia specialists has just published an article in the journal Blood asking for a real dialog with the biopharmaceutical industry about the constantly increasing costs associated with new (and older) drugs for the treatment of this form of cancer.

This article by Kantarjian et al. is freely available on line, and has been extensively covered in the media (see for example the articles in The New York Times and in The Washington Post).

The cost of drugs for the treatment of cancer and other disorders is becoming a major global issue. On the one hand, it is the profits that can be made from the small number of highly profitable drugs that get approved each year that drive investment in the biopharmaceutical industry. On the other hand, there is a strong argument that if every significant new drug to treat cancers and other rarer disorders is going to come with a price tag of $100,000 and higher, then we are on a path to an unsustainable economic model for new drug development.

For those with a third hand, there is also the perspective currently being “championed” by the Indian government, which is that the Indian population simply cannot afford these sorts of prices in any case — and the Indian government has taken some distinctly radical steps as a consequence, like overturning international patent law!

The “New” Prostate Cancer InfoLink is well aware of the truly massive steps we have been able to take in the development of new drugs for the treatment of prostate cancer in the past 5 years. It is also well aware that those massive steps are still small in terms of the real impact of these new drugs like sipuleucel-T (Provenge), abiraterone acetate (Zytiga), enzalutamide (Xtandi), and cabazitaxel (Jevtana) on patient survival. None of these drugs come with an annual cost of > $100,000 per patient per year, but they are still “getting up there”.

It is worth noting that, in a two-part article in the journal Oncology, Zafar and Abernathy describe what they refer to as the “financial toxicity” associated with the co-pays required from patients for their cancer treatments. (To see the two parts of this article, please click here for Part I and then here for Part II.) In addition, we understand that the American Society of Clinical Oncology (ASCO) has established a working group “to assess including cost and cost-effectiveness data in ASCO’s clinical practice guidelines.”

As we regularly point out on this blog, many European countries have put in place organizations (like NICE in the UK) that are responsible for ensuring that drugs available through their national health authorities meet certain cost-effectiveness criteria. This doesn’t happen in the USA (yet).

The “New” Prostate Cancer InfoLink has no influence over the pricing activities of drug companies. However, we do believe that the biopharmaceutical industry needs to think hard about whether it can better manage its own pricing activities before someone else decides to do it for them. A failure to resolve what is a very real problem could prove catastrophic for one of the world’s truly great industries as well as for the future care of sick patients around the world.

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