Cost vs. benefit of cancer drugs

costbenefit“Is a $30,000-a-month drug that improves survival by 1.4 months effective?  At the ASCO meeting this week, that dialog has already begun. In a forum on drug costs, Dr. Ezekiel Emanuel, The architect of President Barack Obama’s healthcare law, said costs can no longer be ignored. Emanuel reminded his well-heeled audience that the median household income in the United States is $52,000.  So the key questions are these: (1) Is pharma developing cancer drugs that merely extend life for a short period of time knowing they are likely to be approved and (2) Does pharma see these drugs as a “cash cow” because most insurers are not going to deny patients these treatments?

I keep the key findings from research that I led over the years and a couple of years ago research with cancer patients (remission) and general online health seekers told a story.  Overall, most patients said that they probably would not want a drug that could extend life for a short period of time if the quality of their remaining time was not up to “their standards”.

Then there is the complicated world of online information for cancer patients.  Just google and cancer and try and take it all in.  If you’re an empowered patient, it’s almost impossible to understand all the treatment options and choices.  In addition WellPoint is now planning to reward doctors with $350 if they stick to treatment guidelines.  While this may be a good approach how do you think is going to go over with patients who might feel that they are not getting the latest and best treatment?

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The warning shouts on drug costs are loud and clear.  Biopharma companies are going to be limited to how much they can charge for new drugs even though drug costs were only $0.09 of every healthcare dollar spent in 2012 and generic medications accounted for 86% of all Rx’s in 2013.

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The debate on cancer drug costs is focusing on treatment, but realistically we need to focus more on prevention of some cancers.  American’s have to learn that there can be a steep price to pay for living unhealthy lifestyles.   Until ten pharma companies will continue to develop cancer drugs that meet FDA endpoints for approval but only provide a little more time for patients who want a cure or a treatment with a better quality of life.

2 thoughts on “Cost vs. benefit of cancer drugs

  1. ¿What comes first, the egg, or the hen? Should we consider ‘the egg’as the future cancer-when fertilized-, then let’s fire Mr. Cock from the hen-coop!. In this Bible-like `Parable`, the Evil is the Cock, for he entails the Risk Factors (being the hen-coop the Community-sorry about). Namely, again and again, there’s a shortcut applicable for advanced cancer’s costly treatments & suffering : about 60 % of cancers ‘would-be’today either avoidable or, by screening, early curable. So, it’s a Health-Politics tough decision, I agree. But someone has to take it, right now!

  2. Seems like the right place to raise a question I have wondered about. It strikes me that when it comes to cancer survival, the numbers patients and oncologists should want are the median and the range, not the average. In this case, the average of 1.4 months might be hiding a distribution where a significant number of patients received extended benefit. Surely, this should be considered in determining the risk/cost/benefit?

    A related point is the flow of knowledge. Many assume that genetic targeting starts at the benchtop and then slowly becomes associated with a drug that works. If there is a wide distribution in the patient population for this drug (I don’t know), then ultimately it might be discovered that there is a genetic or environmental reason for the distribution. We just might not discover that until it hits the market and have a large enough N to find the pattern or subsequent science makes the discovery possible. At that point, the hit rate can be greatly increased by patient selection.

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