MA07.11 Drug Price Comparison in Advanced Lung Cancer – High Cost Prices is Accompanied by Patient Benefits?

Abstract

In our recent decade we are seen new drugs coming up with high speed development to attend personalized conditions in lung cancer treatment. After the first TKI for EGFR mutation, many other target drugs such as TKI for ALK/ROS1 alteration, third-generation EGFR TKI, anti-PD-1/PD-L1 immunotherapies bring together an improvement in survival with better quality of life than chemotherapies. But this new specialty drugs are also testing the affordability of the market with new launched ceiling prices. Frequently, their prices have been settled down in a context of an unmet condition appeal rather than the truly health benefits. In pricing it is a common practice to use the external reference price between countries to align the prices based on international market. But if the first price is launched (frequently in USA) in countries that don’t use metrics based on evidence or clinical benefits, the price plateau could be replicated even without necessarily deserving this price. The objective of this presentation is to show the price comparison of drugs included in TKI class and immunotherapy class between high and middle-income countries. Then to compare the cost-treatment of therapies commonly used in advanced lung cancer and their magnitude of clinical benefit. All local currencies were converted to US dollars using PPP factor. The magnitude of effect was evaluated based on the ESMO Magnitude of Clinical Benefit Score. USA has the highest drug price followed by Brazil, especially in recent launched drugs. Costs of advanced lung cancer treatment significantly increase 5 times more when compared first-generated TKI and new generation TKI. Immunotherapy for second line costs 6 times more than first line with EGFR TKI and could cost more than 7 to 130 times the chemotherapy with docetaxel. Clinical benefits do not reach the same scale. The market of anticancer drug increasing 10% annually, but clinical benefits don’t advance in the same compass. Specialized drugs come into the market with pricing warrant of unmeet conditions, but if we think in precision medicine all new drug-target biomarker could be priced higher because it will cover a rare or unmet condition. In the context of precision medicine, is it fear a patient pays more because he has a different biomarker for the same clinical condition? If countries do not start to evaluate and pricing drugs based on value, market strategists will continue to test the ceiling price that health systems can(not) afford.