Researchers say initial prices of new cancer
drugs are six times higher, raising the question of if patients are getting
their money’s worth.
For some
cancer patients, taking a new cancer drug is simply a matter of buying time.
It turns
out, though, they are paying a lot for those extra months and years.
A study
published today in JAMA Oncology reports that new cancer drugs taken in pill
form have become dramatically more expensive in their initial year on the
market than other drugs launched 15 years ago.
In
addition, the researchers say, the prices of those drugs increase rapidly even
after their first year on the market.
Dr. Alan
Venook, an oncologist at the University of California, San Francisco, notes
that many of these drugs are not even cures. They simply delay the progression
of cancer.
“It’s
beyond me. I guess they do it [raise prices] because they can do it,” Venook
told Healthline. “It’s a big, big problem.”
The Price of Treatment
Researchers
looked at 32 orally administered drugs introduced since 2000.
They said
the average monthly cost of the drugs approved in that year was $1,869.
That
figure rose to $11,325 a month for new drugs introduced in 2014. That’s a
sixfold increase, even after adjusting for inflation.
One of
the drugs highlighted in the research was imatinib, also known by the brand
name Gleevec. When it was launched in 2001, the average monthly cost was
$3,346. In 2014, that monthly cost had risen to $8,479. That’s an average
annual increase of 7.5 percent.
The
researchers said the amount paid by health insurance companies was factored
into the cost. They also pointed out that many patients are now paying a higher
percentage of these expenses than they were 15 years ago.
"Patients
are increasingly taking on the burden of paying for these high-cost specialty
drugs as plans move toward use of higher deductibles and co-insurance — where a
patient will pay a percentage of the drug cost rather than a flat copay,"
said study author Stacie Dusetzina, Ph.D., an assistant professor at the
University of North Carolina, in a press release.
Officials
at the Pharmaceutical Research and Manufacturers of America (PhRMA) said the
dramatic improvements in cancer treatment over the past decade have helped
people live longer, healthier lives.
They
noted the cancer death rate in the United States has fallen 23 percent since
its peak and two of three patients diagnosed with cancer now live at least five
years after diagnosis.
They
added there has been a rapid rise in healthcare plans with high deductibles for
medicine.
"Focusing
solely on the list prices of medicines is misleading,” Holly Campbell, senior
director of communications for PhRMA, told Healthline in an email. " A new
report from the IMS Institute found net prices for brand medicines increased
just 2.8 percent in 2015, down from 5.1 percent the prior year as discounts and
rebates negotiated by payers rose sharply. Similarly, CVS Health and Express
Scripts recently reported actual medicine spending growth in 2015 was less than
half from the prior year. This is due to a competitive marketplace for
medicines where large, powerful purchasers negotiate aggressively."
Is It Worth It?
The price
increases bring up two questions.
Who can
afford the drugs, and are they getting their money’s worth?
Venook
said cancer patients are sometimes put into the position of deciding if they
want to drain their finances to slow the progression of their disease.
He has
one patient who has been taking Gleevec for years. It’s been effective, but the
woman recently decided to take the pill only four times a week to save money.
Venook
said the prices also put doctors in a predicament. They want the best for their
patients, but that might not always involve taking the latest cancer drug,
especially if it’s uncertain how well it will work on a particular patient.
Venook
said Gleevec can have good results, so it may be worth the cost.
“It’s a
very effective drug,” said Venook. “With that one, they should be able to
charge a premium.”
Some of
the newer drugs for hepatitis C have also been effective. In some cases, they
have cured the disease and allowed patients to forgo expensive treatments such
as liver transplants.
“That
makes a world of difference to patients,” Venook noted.
Price Based on Value?
Venook
said perhaps the best way to regulate the situation is to approve policies that
require companies to set prices based on how much benefit certain drugs
provide.
He
suggested that perhaps a new drug could be given to a patient for free for two
months. If it’s effective, then a company could start charging for it.
“The only
fair way is to price drugs according to their value,” said Venook.
Dr. Len
Lichtenfeld, deputy chief medical officer for the American Cancer Society, said
that’s what’s happening in some countries in Europe and other places.
He told
Healthline that some European nations will pay a company more for a drug if
it’s effective.
He added
Medicare officials in the United States are considering a plan to set payments
for drugs based on how effective they are against certain diseases.
If a drug
works well in treating lung cancer, for example, the pharmaceutical company
would be paid more when it’s used on lung cancer patients than when it’s used
less effectively on, say, colon cancer patients.
“The
solutions are not going to be simple,” said Lichtenfeld. “There has to be a
balance.”
Cancer Drugs Aren’t the Only Ones
Cancer
drugs aren’t the only pharmaceuticals with a spotlight on them.
On
Wednesday, Michael Pearson, the outgoing chief executive officer of Valeant
Pharmaceuticals International, told a Senate committee that his firm was too
aggressive in raising prices on its drugs.
Valeant
acquired the rights to the cardiac-care drugs Isuprel and Nitropress last year.
They quickly raised the medications’ prices by 525 percent and 212 percent,
respectively, according to the Wall Street Journal.
In
addition, the prices of 16 Valeant drugs have increased this year.
The
company is under investigation by the Security and Exchange Commission (SEC)
and other agencies, the Wall Street Journal reported.
Pearson
told the Senate Special Committee on Aging that Valeant has spent $1 billion to
help patients afford the cardiac drugs.
However,
he acknowledged Valeant’s strategy of acquiring drugs that needed hefty price
increases was a mistake.
His
testimony came less than three months after Martin Shkreli, the former chief
executive of Turing Pharmaceuticals, refused to answer questions at a House
committee hearing on the rising price of drugs.
Turing
made the news last year when the company bought the rights to the drug Daraprim
and then raised the price per pill from $13 to $750.
Another
pharmaceutical company, Gilead, made news in 2014 when it started selling the
drug Sovaldi for $84,000 for a 12-week treatment regimen.
The drug
has a 95 percent cure for hepatitis C.
These and
other price hikes have led many consumer advocates to question why some
prescription drugs cost so much and others don’t.
This
spring the Federal Drug Administration (FDA) quietly started a program to speed
up the drug approval process to help avoid future price gouging.
The goal
is to bring more drugs onto the market, thus increasing competition and forcing
down the prices of prescriptions.
David
Mills
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