Doctors and researchers, who specialize in the potentially deadly blood cancer known as chronic myeloid leukemia, contend in a commentary published online by a medical journal Thursday that the prices of drugs used to treat that disease are astronomical, unsustainable and perhaps even immoral.They suggested that charging high prices for a medicine needed to keep someone alive is profiteering, akin to jacking up the prices of essential goods after a natural disaster and they are quite correct. It comes down to a very simple principle; drug companies understand that no insurer is going to turn down the request of a patient with cancer for medication even if the medication will only keep them alive for a short while with a deteriorating quality of life.
According to the NY Times “Among the critics is Dr. Brian Druker, who was the main academic developer of Gleevec and had to prod Novartis to bring it to market.Novartis argues that few patients actually pay the full cost of the drug and that prices reflect the high cost of research and the value of a drug to patients. Gleevec entered the market in 2001 at a price of about $30,000 a year in the United States, the doctors wrote. Since then, the price has tripled, it said, even as Gleevec has faced competition from five newer drugs. And those drugs are even more expensive.
Some of the doctors who signed on to a commentary on the high prices of drugs said they were inspired by physicians at the Memorial Sloan-Kettering Cancer Center in New York, who last fall refused to use a new colon cancer drug, Zaltrap, because it was twice as expensive as another drug without being better. After those doctors publicized their objections in an Op-Ed article in The New York Times, Sanofi, which markets Zaltrap, effectively cut the price in half.
“If you are making $3 billion a year on Gleevec, could you get by with $2 billion?” Dr. Druker, who is now director of the Knight Cancer Institute at Oregon Health and Science University, said in an interview. “When do you cross the line from essential profits to profiteering?” Gleevec’s sales were $4.7 billion in 2012, making it Novartis’s best-selling drug. A newer Novartis leukemia drug, Tasigna, had sales of $1 billion. Novartis did say said that it provided Gleevec or Tasigna free to 5,000 uninsured or underinsured Americans each year and to date had provided free drugs to more than 50,000 people in low-income countries.
The debate around drug prices is not going to go away but at some point in time an insurer or the FDA is going to have to say no to new cancer drugs that do not have clinical proof that they work better than current drugs on the market. Patients also are having more of a say as an article last year in Time magazine indicated that some cancer patients would rather forgo treatment than deal with drugs that detract from the quality of life to live a few months longer. As a society we need to determine if keeping someone alive for a few weeks more is worth hundreds of thousands of dollars. The problem is nobody can answer that question until they are in the position to refuse treatment or accept treatment to stay alive a few more months.