VIDEO: Policy makers ‘cannot be excused’ from dialogue on immunotherapy cost

Bartosz Chmielowski, MD, PhD, of the UCLA Jonsson Comprehensive Cancer Center, discusses the costs of immunotherapy and explores whether the treatment is affordable — for society, patients and physicians — and how decisions to utilize it should be made.

“It’s a difficult question when you sit in the office and face a patient, and you are talking about the best choice of treatment and you believe immunotherapy is the right treatment,” he said. “Immunotherapy is not cheap.”

In context of the cancers in which the “breakthrough” treatment is already being applied and the others on the horizon, Chmielowski weighs the costs of the CTLA-4 inhibitor ipilimumab (Yervoy, Bristol-Myers Squibb) and the anti–PD-1 antibodies nivolumab (Opdivo, Bristol-Myers Squibb) and pembrolizumab (Keytruda, Merck) with consideration for their dosing regimens and duration of use.

He argues that the quick, complete and durable responses many patients experience suggest immunotherapy may be less expensive in the long term. “The cost of a shorter treatment actually might be lower than multiple lines of therapy not leading to prolongation of survival.”

Chmielowski highlights it is “easy” to put responsibility in the hands of physicians and patients and points to the key role of policymakers in negotiating prices with pharmaceutical companies. “It’s been done in other countries — it can be done here in the United States.”

Finally, he talks about the “different ways” physicians are viewing the cost challenges, touching on research investigating both lower doses, sequencing and shortening the duration of therapy.