July 28, 2015
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Oncologists criticize high drug costs, propose cost-cutting measures

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Over 100 U.S. oncologists have issued a statement deriding the high cost of cancer drugs and calling for new regulations to mitigate expenses.

Authors of the statement — published in Mayo Clinic Proceedings — recommended the creation of a post-FDA approval price review process and the importation of foreign cancer drugs for personal use, among other suggestions.

“High cancer drug prices are affecting the care of patients with cancer and our health care system,” Ayalew Tefferi, MD, a hematologist and professor of medicine at Mayo Clinic in Rochester, Minnesota, said in a press release. “The average gross household income in the U.S. is about $52,000 per year. For an insured patient with cancer who needs a drug that costs $120,000 per year, the out-of-pocket expense could be as much as $25,000 to $30,000 — more than half their average household income.”

The authors cited a study by Howard and colleagues, published in Journal of Economic Perspectives (Howard DH, et al. J Economic Perspect. 2015;doi:10.1257/jep.29.1.139.), which determined that the cost of cancer drugs rose by $8,500 per year over a 15-year period. After adjustment for inflation, the cost of drugs for each additional year lived increased from $54,000 in 1995 to $207,000 in 2013.

Tefferi and colleagues introduced seven actions that could reduce the cost of cancer drugs and improve the ability for patients to receive adequate treatment. These actions included:

  • The creation of a post-FDA drug approval review mechanism to propose a fair price for new treatments, based on the value to patients and health care;
  • Allowing Medicare to negotiate drug prices;
  • Allowing the Patient-Centered Outcomes Research Institute — which the Affordable Care Act initiatives created to evaluate the benefits of new treatments — and similar organizations to include drug prices in their assessments of treatment value;
  • Allowing the importation of cancer drugs across borders for person use, citing that cancer drugs in Canada are usually half the price of their U.S. equivalents;
  • Reform of the patent system to make it more difficult to unnecessarily extended product exclusivity;
  • Passing legislation to prevent drug companies from delaying access to generic drugs; and,
  • Encouraging organizations that represent oncologists and patients — such as ASCO, American Society of Hematology, American Association for Cancer Research and American Cancer Society — to consider the overall value of drugs and treatments when formulating treatment guidelines.

A total of 118 U.S. oncologists endorsed these recommendations.

“When you consider that cancer will affect one in three individuals over their lifetime, and with recent trends in insurance coverage that put a heavy financial burden on patients with out-of-pocket expenses, you quickly see that the situation is not sustainable,” Tefferi said. “It is time for patients and their physicians to call for change.” – by Cameron Kelsall

Disclosure: Please see the full article for a list of all authors’ relevant financial disclosures.