Global variation in cancer drug prices does not reflect affordability

CHICAGO — Despite global variance in cancer drug prices, generic and patented drugs are less affordable in low-income countries, according to a pilot study presented at the ASCO Annual Meeting.

“There are major differences in the retail prices of drugs globally and these differences are not proportional to the ability of citizens to pay for them,” Daniel A. Goldstein, MD, senior physician in medical oncology at Rabin Medical Center in Petah Tikva, Israel said in a press briefing. “Despite the lower prices in countries with less wealth, [cancer] drugs are relatively unaffordable, and despite the U.S. being the wealthiest country, drugs are also relatively unaffordable.”

The price of cancer drugs differs globally, but the magnitude and nuance of these price differences had not been fully understood.

Goldstein and colleagues sought to understand the difference in prices of cancer drugs in the United States, South Africa, Israel, China, India, Australia, and the United Kingdom, and how those prices related to affordability. All data on Isreal were not included in the presentation.

The analysis included data on 23 cancer drugs, 15 of which were generic. The eight patented drugs included bevacizumab (Avastin, Genentech), bortezomib (Velcade, Takeda/Millennium), dasatinib (Sprycel; Bristol-Myers Squibb, Otsuka), erlotinib (Tarceva; Genentech, Astellas Oncology), imatinib (Gleevec, Novartis), pemetrexed (Alimta, Lilly), rituximab (Rituxan; Genentech, Biogen) and trastuzumab (Herceptin, Genentech).

Researchers calculated the retail price of the drug in each country for 1 month of therapy and converted the price to U.S. dollars based on the Jan. 19, 2106 exchange rate.

To evaluate affordability, researchers used gross domestic product at purchasing power parity, which indicates a country’s standard of living and takes into account the relative cost of living.

Results showed the United States had the highest median monthly prices in U.S. dollars for both patented ($8,694) and generic ($645) drugs, followed by China (patented, $3,173; generic, $532), the United Kingdom (patented, $2,587; generic, $458), Australia (patented, $2,741; generic, $226), India (patented, $1,515; generic, $159) and South Africa (patented, $1,708; generic, $120).

The median monthly price as a percentage of gross domestic product per capita showed that generic drugs are the least affordable in China (48%), followed by India (33%), the United Kingdom (14%), the United States (14%) and South Africa (11%). Generic cancer drugs appeared most affordable in Australia (3%).

The same model showed that patented drugs were least affordable in India (313%), followed by China (288%), the United States (192%), South Africa (157%), Israel (approximately 85%), the United Kingdom (78%) and Australia (71%).

Researchers acknowledged the study did not take into account the health insurance systems in different countries.

“Deeper analysis of prices data showed in this pilot study are needed,” Goldstein said. “Some of these drugs are curative, but some improve survival by only a few months. Understanding efficacy is essential to understanding price and affordability.” – by Nick Andrews

Reference :

Goldstein DA, et al. Abstract 6500. Presented at: ASCO Annual Meeting; June 3-7, 2016; Chicago.

Disclos ure: Goldstein reports no relevant financial disclosures. One researcher reports a consultant/advisory role with Novartis and travel accommodations from Genomic Health.