PCN16 Comparison of the Efficacy and Cost of Novel Targeted Cancer Therapies

Abstract

For several years, cytotoxic agents have been the backbone of cancer treatment. There has increasingly, however, been an emergence of new drugs that are more specific to the target molecule. Some of these novel agents have resulted in a prolongation of survival and even clinical cures in some cancers. In order to assess the costs and overall benefits of these new drug therapies, a descriptive evaluation across seven major tumor types was undertaken. A literature search was conducted from 2000 to 2011 to identify randomized trials of novel therapies in breast, lung, colorectal, kidney, lymphoma, multiple myeloma and chronic myelogenous leukemia. Clinical outcomes in terms of progression free (PFS) and overall survival (OS) benefit were extracted. Economic data in terms of cost per month of therapy was obtained from a U.S. cancer clinic. Almost 22 novel therapies were approved across the seven cancers. Four of the 22 (18%) were used with a curative intent while the remainder were used in the palliative setting (n=18). Ten of these 18 latter agents (56%) also demonstrated an OS benefit. The median month cost for novel therapies used with a curative intent and those with a survival benefit in the palliative setting were $5450 and $6450 respectively. In contrast, the median monthly cost for drugs that did not offer either of these benefits was $7900. Of the agents identified, imatinib, lenalidomide, rituximab and trastuzumab provided the greatest magnitude of benefit for both PFS and OS and would be considered major clinical advances. Approximately 64% of novel cancer drugs approved over the past 11 years are used with a curative intent or provide a survival benefit in the palliative care setting. However, the monthly cost for agents not providing these benefits was higher, indicating a disconnect between efficacy and cost.