What’s three more months of life worth?

  • The cost of new anti-cancer drugs increased more than fivefold from 2006 to 2015.
  • Anticancer medications account for the lion’s share of global drug spending, and the average price per month of these drugs is known to have more than doubled in recent years
  • Cost is not connected with benefit, and cost is going up quickly, and benefit is highly variable.
  • ASCO and other groups are supporting efforts to make cancer drug costs relate to their effectiveness.

Anticancer medications account for the lion’s share of global drug spending, and the average price per month of these drugs is known to have more than doubled in recent years, Dr. Kelvin Chan of Sunnybrook Health Sciences Centre in Toronto and colleagues note in the Journal of Oncology Practice.

“Global spending on cancer medicines — both for therapeutic and supportive care use — rose to $133 billion globally in 2017, up from $96 billion in 2013,”

Chan’s team used two scales, the American Society of Clinical Oncology (ASCO)’s Value Framework and the European Society of Medical Oncology’s (ESMO) Magnitude of Clinical Benefit Scale, to measure clinical benefits of the newly approved drugs. Neither scale showed any improvement in clinical benefit over time, nor were there any associations between the clinical value of a drug and its monthly or incremental cost.

In addition an analysis of anticancer drugs approved by the US Food and Drug Administration (FDA) between January 2012 and December 2017 revealed that breakthrough-designated anticancer drugs were associated with faster times to approval. However, there was no evidence that these drugs provide improvements in safety or novelty, nor there was a statistically significant advantage in efficacy when compared with non–breakthrough-designated anticancer drugs. The findings are published in the Journal of Clinical Oncology.

To date the FDA and insurance companies have been unlikely to deny cancer patients possible life saving medications and the pharma companies know this which is why they all want a piece of the pie, but with costs escalating so much we are eventually going to ask “is this drug worth the money?”.

We are making good inroads in our battle with cancer, but cancer is not just one disease, it’s many and is very complex even within the same cancer diagnosis.  Can we afford a treatment that costs a lot of money even though it may only prolong life by a couple of weeks or are we going to move to a “pay for performance model”?

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