Abstract
A new report from the IMS Institute for Health Care Informatics concludes that the cost of cancer drugs is continuing to rise, but at a slower rate than in past years.
At a time when the United States is struggling to bring down health care costs, every new cancer drug seems to come with a large price tag. For example, therapy with ipilimumab for melanoma costs nearly $120,000 for 12 weeks, the median treatment time.
Cost concerns are so high that researchers at this year's American Society of Clinical Oncology annual meeting, which took place from May 30 to June 3 in Chicago, IL, were asked to include a discussion about value in presentations about medicines, along with their scientific results.
However, costs have actually moderated, according to Murray Aitken, executive director of the IMS Institute for Healthcare Informatics, the research and insights division of Danbury, CT–based IMS Health, which provides data, information services, and technology for the health care industry. In a new report, the IMS Institute concludes that spending on cancer drugs in the United States is rising by about 3.5% per year—not as rapidly as some people may think.
Worldwide, spending on cancer drugs increased at a rate of 5.4% annually from 2008 to 2013, reaching $91 billion in 2013, compared with an annual growth rate of more than 14% from 2003 to 2008.
“It's a little different to the conventional narrative that cancer drug costs are out of control,” Aitken says.
Most of the expensive, cutting-edge new therapies are being used by a relatively small number of people, Aitken says by way of explanation. Many innovations from 10 to 15 years ago are now losing their patents, like Sanofi's Eloxatin (oxaliplatin) for colon cancer, and therefore aren't as costly.
“If you only look at expensive drugs, you'll find costs are going up,” he says. “But if you look at the totality, you see a different picture.”
Leonard Saltz, MD, isn't ready to say that problem of rising drug costs has been solved. Saltz, chief of the Gastrointestinal Oncology Service at Memorial Sloan Kettering Cancer Center in New York, NY, and chairman of its Pharmacy and Therapeutics Committee, predicts that the rate of cost increases will accelerate again soon, as new drugs replace older ones that are coming off patent.
Although the new drugs provide statistically significant improvements in survival, the actual benefit may be short-lived. Either the cost of individual drugs will have to come down, Saltz says, or society will need to have some serious conversations about how much we're willing to pay to provide someone with a few extra weeks, months—or even years—of life. In addition, he says, every drug is priced as if it will live up to its initial promise, but most drugs don't perform as well in the real world as they did in trials.
Saltz says he's particularly worried about new combination therapies that will easily exceed $250,000 for a single course of the drugs alone; repeated treatments, supplemental therapies, and nursing and medical care add to the cost. Furthermore, most of these treatments are now given to patients who have already failed the standard of care.
“There's pretty universal agreement that the current situation is not sustainable,” he says.