The Rising Costs of Cancer Drugs — New York Magazine
▻http://nymag.com/news/features/cancer-drugs-2013-10
New drugs could extend cancer patients’ lives—by days. At a cost of thousands and thousands of dollars. Prompting some doctors to refuse to use them.
Avastin, $5,000/month; Zaltrap, $11,000/month; Yervoy, $39,000/month; Provenge, $93,000/course of treatment; Erbitux, $8,400/month; Gleevec, $92,000/year; Tasigna, $115,000/year; Sprycel, $123,000/year.
#cancer #big_pharma
In 1965, at the dawn of Medicare, the chemotherapy drug Vinblastine cost $78 a month, according to a widely cited Sloan-Kettering price compendium. In 2011, Bristol-Myers Squibb introduced a new melanoma drug called Yervoy at a cost of about $38,000 a month for a three-month treatment.* Yervoy followed, by about a year, a new prostate-cancer therapy called Provenge that cost $93,000 per course of treatment. Even an ancient chemotherapy like nitrogen mustards, cousins to World War I’s mustard gas and in use since 1949, have gotten caught in the cost updraft; in 2006, a course of treatment experienced a thirteenfold price increase, from $33 a month to $420 a month.
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“What predicts the price of the next cancer drug is the price of the last cancer drug,” says Bach. “The only check on the system is corporate chutzpah.”
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Just last week, a New England Journal of Medicine editorial characterized high drug prices as a form of “financial toxicity.”
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“Whereas we had hoped that small, incremental gains would be a springboard to something bigger and more productive, I fear those small, incremental gains have become a business model. Right now, it is safer for a pharmaceutical company to strategize for large-scale clinical trials that look for small, incremental gains that will get a drug to market, than to swing for the fences and try for the big advance.”
It’s not just that the skewed market for cancer drugs rewards mediocre products, he says. “Mediocrity is so well rewarded that it’s a better risk than aiming higher.”
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Over the past decade, Kantarjian watched in disbelief as the cost of a successful leukemia drug called #Gleevec rose. “I was shocked that it had tripled since 2001,” he says, “and there was no reason for the increase in price, except that the companies could do it and nobody could do anything about it.” Kantarjian, as established a figure as there is in American oncology, suddenly became #radicalized.
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Patients with cancer are 2.5 times as likely to declare bankruptcy as the general population
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As a result [of #NICE], a British cancer patient usually pays substantially less than American patients. Gleevec costs about $33,500 a year in England, according to NICE; the U.S. price ranges up to $92,000 (according to the Blood editorial). Tasigna, a newer CML drug, costs about $51,000 in England, while the U.S. price ranges up to $115,000. Sprycel, another new CML drug, costs nearly $49,000 a year in England, while the U.S. price ranges up to $123,000.
More to the point, NICE has recently said no where Medicare has been forced to say yes. In January 2012, NICE declined to approve Avastin for both colon and breast cancer, and last June, NICE reached the same conclusion about Zaltrap as Sloan-Kettering’s physicians—it declined to cover the use of the drug, considering it too expensive.
