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Cost of cancer care under scrutiny, projected to keep rising
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ORLANDO — The market for cell therapy has drastically evolved over the last several years, leading to new reimbursement strategies for companies and patients, according to a presenter at Community Oncology Alliance Conference.
The costs for treating patients with cancer and developing new therapies has been controversial over the past 10 years. The production of chimeric antigen receptor T-cell therapy has contributed a lot to that discussion, the presenter added.
“I think it’s appropriate to see where we’ve come from and why we talk about value-based pricing,” Richard T. Maziarz, MD, medical director of the adult blood and marrow stem cell transplant and cellular therapy program at Oregon Health & Science University, said during the presentation. “In oncology, we’re part of the top 5% in spending. But, overall, how we spend money in this country has been a big focus over the past decade. Cancer drugs outstrip cancer medical care which then outstrips health care expenditure. The care of cancer patients has a target on its chest.”
The U.S. national cancer care expenditures were estimated to be $124.6 billion in 2010. That number will rise to an estimated $157 billion in 2020.
Total spending on anticancer drugs increased from $26.8 billion in 2011 to $42.1 billion in 2016.
About 14% of those costs were considered “waste,” meaning they did not add value or improve patient outcomes, Maziarz said.
CAR T-cell therapy products, meanwhile, are poised for a huge increase in worth and spending within the next 10 years.
The global CAR T market is currently evaluated at an estimated $72 million. By 2028, that number is projected to be $3.3 billion because there are over 150 CAR T-cell trials currently in the clinical pipeline.
The CAR T treatment tisagenlecleucel (Kymriah, Novartis) costs $475,000 for patients with acute lymphoblastic leukemia and $373,000 for patients with non-Hodgkin lymphoma.
CAR T therapies that are a one-time use instead of a repeated treatment could help bring down costs, Maziarz said. However, value and quality assessments are needed. and the balance between cost and the benefit of having a one-time treatment need to be weighed.
“The National Institute for Health and Care Excellence in England knew that CARs were coming and did an analysis of CARs in patients with ALL,” Maziarz said. “They are measuring the impact of the treatment on the burden of the disease over a lifetime. If you cure someone, they go back to work. If you cure a kid, they will go to work for a lot of years.” - by John DeRosier
Reference:
Maziarz R. CAR-T: exploring clinical efficacy & toxicity, value assessment, reimbursement issues & challenges. Presented at: Community Oncology Alliance Conference; April 4-5, 2019; Orlando.
Disclosures: HemOnc Today could not confirm Maziarz’s relevant disclosures at time of reporting.