Paying a high price for cancer drugs

Abstract

Results of research from the early Breast Cancer Triallists' Collaborative Group in Oxford, UK, published in The Lancet on July 24, 2015, were encouraging. They showed that use of adjuvant bisphosphonates in the treatment of early breast cancer in postmenopausal women could reduce disease recurrence and mortality. Bisphosphonates, available in generic form, are inexpensive and should be available worldwide to improve care in this population.Just a day earlier, a commentary published in Mayo Clinic Proceedings was co-signed by 118 US cancer physicians, entitled “In Support of a Patient-Driven Initiative and Petition to Lower the High Price of Cancer Drugs”. The article sets out some sobering facts: the price of new cancer drugs in the USA has increased five-to-tenfold in the past 15 years; in 2014, all new US Food and Drug Administration (FDA)-approved cancer drugs were priced higher than US$120 000 per year of use; and recent trends in the medical insurance industry have pushed user contributions up to 20–30% of drug costs, despite the average annual US household income being around $52 000.The Mayo Clinic Proceedings commentary also draws attention to ways in which the high pricing of cancer drugs could be challenged, including a fair pricing review process after FDA approval, which would allow Medicare to negotiate drug prices and to open up drug imports from neighbouring countries, notably Canada, where drug pricing is around half that of the USA. An online petition, seeking 1 million signatures to amplify concerns in a grass-roots campaign, is gathering momentum.WHO has recently added 16 new cancer drugs to its Essential Medicines List, including imatinib for the treatment of chronic myeloid leukaemia, which costs around $100 000 per year of use. WHO considers the core list to represent “the minimum medicine needs for a basic healthcare system”. It therefore seems depressingly clear that industry's inflated pricing of new cancer drugs is contributing to a failure of health systems to offer promising new therapies to the very people for whom the drugs are created—cancer patients worldwide. Results of research from the early Breast Cancer Triallists' Collaborative Group in Oxford, UK, published in The Lancet on July 24, 2015, were encouraging. They showed that use of adjuvant bisphosphonates in the treatment of early breast cancer in postmenopausal women could reduce disease recurrence and mortality. Bisphosphonates, available in generic form, are inexpensive and should be available worldwide to improve care in this population. Just a day earlier, a commentary published in Mayo Clinic Proceedings was co-signed by 118 US cancer physicians, entitled “In Support of a Patient-Driven Initiative and Petition to Lower the High Price of Cancer Drugs”. The article sets out some sobering facts: the price of new cancer drugs in the USA has increased five-to-tenfold in the past 15 years; in 2014, all new US Food and Drug Administration (FDA)-approved cancer drugs were priced higher than US$120 000 per year of use; and recent trends in the medical insurance industry have pushed user contributions up to 20–30% of drug costs, despite the average annual US household income being around $52 000. The Mayo Clinic Proceedings commentary also draws attention to ways in which the high pricing of cancer drugs could be challenged, including a fair pricing review process after FDA approval, which would allow Medicare to negotiate drug prices and to open up drug imports from neighbouring countries, notably Canada, where drug pricing is around half that of the USA. An online petition, seeking 1 million signatures to amplify concerns in a grass-roots campaign, is gathering momentum. WHO has recently added 16 new cancer drugs to its Essential Medicines List, including imatinib for the treatment of chronic myeloid leukaemia, which costs around $100 000 per year of use. WHO considers the core list to represent “the minimum medicine needs for a basic healthcare system”. It therefore seems depressingly clear that industry's inflated pricing of new cancer drugs is contributing to a failure of health systems to offer promising new therapies to the very people for whom the drugs are created—cancer patients worldwide.