Skyrocketing Costs

As clinicians know well, some patients will want an emerging therapy even with limited data while others will be more concerned about the expected side effects.

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Researchers at the Mayo Clinic have been investigating the costs of cancer therapies and found that although 85% of cancer basic research is funded through taxpayers’ money, Americans with cancer pay 50% to 100% more for the same patented drug than patients in other countries.3

Study investigator S. Vincent Rajkumar, MD, who is with the Mayo Clinic Cancer Center in Rochester, MN, said oncologists have a moral obligation to advocate for affordable cancer drugs.

Dr. Rajkumar and his colleague, Hagop Kantarjian, MD, professor and chairman of the Department of Leukemia at The University of Texas MD Anderson Cancer Center in Houston, TX, found that the average price of cancer drugs for about a year of therapy increased from $5,000 to $10,000 before the year 2000 to more than $100,000 by 2012.

They said this occurred at the same time as the average household income in the United States decreased by about 8%.

“We need to create a post FDA approval panel that will review the price of a drug after it’s approved and make some recommendations as to a reasonable and fair price for the drug,” said Dr. Kantarjian.

Dr. Kantarjian believes there are many reasons for the high cost of cancer drugs, including legislation that prevents Medicare from being able to negotiate drug prices and a lack of value-based pricing.

He said now is the time for Medicare to negotiate drug prices and develop cancer treatment pathways/guidelines that incorporate the cost and benefit of cancer drugs. He also said allowing the importation of drugs from abroad for personal use could put pressure on the pharmaceutical industry.

“To allow patients to import drugs across borders is important. We pay 2 to 3 times for a drug than they pay in Canada and Mexico. There is no reason why a patient can’t go and get a drug they can’t afford in the United States. That is not allowed,” Dr. Kantarjian said in an interview with Cancer Therapy Advisor. “If we can allow patients to import drugs for one-third of the price, then I think it will put pressure on the drug companies to lower prices.”

Peter Bach, MD, MAPP, director of Memorial Sloan Kettering’s Center for Health Policy and Outcomes, has focused on the cost and value of anticancer drugs.

He believes that significant changes are required with how Medicare assesses new anticancer therapies and would like Medicare to be empowered to experiment with new programs that help control costs.4

He wrote that one program worth considering is a “payment for results,” which would mean reimbursing only for a drug if it shows some efficacy.

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Dr. Bach contended that with each advance in treatment, the magnitude of the increase in the cost of treatment exceeds the magnitude of improvement in efficacy— thus making each new treatment advance less cost-effective than the one before it.