The increasing high costs of drugs for cancer therapy

The news junkies among our readers probably already know this, but …. Last night, on air and on its web site, 60 Minutes spent 20 of those minutes addressing the increasingly high cost of cancer medications. The CBS correspondent, Lesley Stahl, stated that:

They are so astronomical that a growing number of patients can’t afford their co-pay.

The piece carried interviews with several doctors who have already criticized the pricing of new (and older) cancer therapies, which can now, typically, cost more than $100,000 per patient per year. They also interviewed John Castellani, the president of the trade and lobbying group, PhRMA, which represents the pharmaceutical industry in Washington, DC. Mr. Castellani stated that:

The drug companies have to put a price on a medicine that reflects the cost of developing them, which is very expensive and takes a long period of time, and the value that it can provide.

Commenting on the program, Matt Herper, in an article in Forbes writes that

… the pharmaceutical industry, which only provided canned statements and badly thought-out explanation via the president of its lobbying group, came off looking callous and insensitive. … it might be time for drug industry executives to think out loud about how to decide what will limit cancer drug costs, and when costs should be high — before someone else does that thinking for them.

Also, last Friday, The Philadelphia Inquirer reported on an article by Dr. Peter Bach in the Journal of American Medical Association that questions the medical value of some high-cost medications. Dr. Bach, who we have referred to before, and who heads up the Health Outcomes Research Group at Memorial Sloan-Kettering Cancer Center, and has long been an aggressive critic of the high prices of new cancer therapies, emphasized the importance of considering “the benefit of a treatment with respect to its cost.”

Now we do know that senior executives within the pharmaceutical industry are well aware of the problem. In his article Herper quotes the following statement from the CEO of Novartis, which has developed, is developing, and markets several drugs used in the treatment of various cancers (although none for the treatment of prostate cancer):

The whole oncology pricing structure needs to be rethought because it’s reached the level that is not going to be sustainable for the long term.

It seems that the issue of the prices of new drugs in general — and new drugs for cancer treatment in particular — is heating up. And The “New” Prostate Cancer InfoLink has said before that the ability to define the real value of each drug to the group of patients that it has been designed to treat is coming under increasing scrutiny. Everyone seems to basically agree on that premise. However, what people mean by “value” seems to be vary different and depends on who you are talking to.

Additional content (as of 14:35 on Monday, October 6, 2014): Apparently, late on Sunday, PhRMA provided some additional context on its Catalyst blog site. What readers may think of this additional information is probably going to depend on what they see as the moral and ethical responsibilities of those who profit from drug development and marketing of biopharmaceuticals. This is not as simple as “right” or “wrong”. It is all about the cultural and related priorities of specific groups of people within the societies in which we live.

4 Responses

  1. Herein lies the real reason Sonocare and Alblatherm’s FDA application was turned down, and the real reason the clincial trials in America cannot be completed … Doctors themselves make about 50% in finders fees on the drugs. (They cited a doctor getting $6,000 cash from prescribing $11,000 in prescriptions). I know first-hand that doctors will not inform a patient that a clinical trial for HIFU is ongoing in their hospital. The trial where Dr. S. Scionti works was completed years ago, and with a much better success rate than where the other uninterested doctors worked. As HIFU will cure most cancers it will be a long time before the FDA approves a treatment with no hospital stay and no drugs needed. I hear Qatar, England and Israel have state of the art wonderful facilities for HIFU.

  2. Dear Ron:

    (1) If Dr. Scionti completed a trial years ago, please, please show us the data!

    (2) However good the facilities are for HIFU in the UK, the data being published by the leading experts on HIFU in the UK do not support the curative outcomes you are claiming. Nor is treatment with HIFU covered by the National Health Service outside of a clinical trial.

    (3) There are certainly physicians who “act badly” by not referring patients to appropriate trials and by making excessive profits from drug therapies, just as there are manufacturers of medical devices who make overblown claims for their products that they cannot actually demonstrate in clinical trials.

  3. We have a Congress that was created 200 years ago with multiple parties to work in a colaborative environment to build consensus. Now we have a US Congress with an approval rating of 13%, that will only work 8 days in the last quarter of 2014, and refuses to compromise on anything. Most Americans want background checks enhanced for gun purchases, as well as want Citizens United overturned, and want some type of regulation for big pharma so people can afford medication. And yet none of these will get passed and instead we seem to accept Congressional ineptitude with overwhelming indifference.

    But for my family, with a son with seizures who was denied health insurance until the ACA came along, his monthly costs for medication were over $650. At what point in time to we give our politicians a metaphoric beat down for enabling huge corporations and billionaires to control so much of our lives, as well as our elections?

  4. I didn’t see the “60 Minutes” broadcast so I can’t comment on that..

    However, I have long been concerned about the costs for some of these treatments, none of which actually cure the disease. Speaking for myself, I am concerned about saddling my wife with huge medical bills for drugs that only provided a few months or years to my survival and only delayed my eventual death. If there were a cure like the one for hepatitis C, I would have no qualms about paying the hefty but one-time cost. But paying huge amounts for a treatment that only defers the inevitable gives me pause.

    So far, thanks to God, Lupron is keeping my cancer in check and I hope it does so for a long time. However, if and when it fails, I will have to decide which additional treatments I will try. The side effects are one issue, of course, but the costs to my family are going to be even more important. I will still be dead. Then again, the newer treatments might just delay my demise until they actually find a cure. Then it would be worth it. Each man (and family) will have to face that decision.

    I just don’t know …

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