Abstract
BackgroundHealth care systems around the world struggle with high prices for new cancer drugs. The purpose of this study was to conduct a gedankenexperiment and calculate how much health expenditures would change if a cure for cancer through pharmaceutical treatment were made available. The cancer cure was conceived to eliminate both cancer deaths and the underlying morbidity burden of cancer. Furthermore, the cure was hypothesized to arrive in incremental steps but at infinitesimally small time intervals (resulting, effectively, in an immediate cure).MethodsThe analysis used secondary data and was conducted from the viewpoint of the German social health insurance. As its underlying method, it used a cause-elimination life-table approach. To account for the age distribution of the population, the study weighted age-specific increases in remaining life expectancy by age-specific population sizes. It considered drug acquisition costs as well as savings and life extension costs from eliminating cancer. All cancer drugs that underwent a mandatory early benefit assessment in Germany between 2011 and 2015/16 and were granted an added benefit were included. Data on age- and gender-specific probabilities of survival, population sizes, causes of death, and health expenditures, as well as data on cancer costs were taken from the German Federal Office of Statistics and the German Federal Social Insurance Office.ResultsBased on the cause-elimination life-table approach and accounting for the age structure of the German population, curing cancer in Germany yields an increase in average remaining life expectancy by 2.66 life years. Based on the current incremental cost-effectiveness ratio of new cancer drugs, which is on average €101,493 per life year gained (€39,751/0.39 life years), the German social health insurance would need to pay €280,497 per insuree to eliminate cancer. Dividing this figure by current average remaining lifetime health expenditures yields a ratio of 2.07, which represents a multiplier of current health expenditures.ConclusionsEliminating cancer at current price levels would more than triple total health expenditures in Germany. As the current price of a cure requires a drastic reduction of non-health consumption, it appears that current prices for cancer drugs already on the market (i.e., small steps towards a cure) need careful reconsideration.
Highlights
Health care systems around the world struggle with high prices for new, innovative cancer drugs
Based on the cause-elimination life-table approach curing cancer in Germany yields an increase in life expectancy at birth by 3.25 life years
We would need to pay on average €270,469 (€101,493 · 2.66) for the cancer cure itself in order to obtain the gains in life expectancy from cancer elimination
Summary
Health care systems around the world struggle with high prices for new, innovative cancer drugs. When setting launch prices of cancer drugs in the U.S over a “typical duration of treatment” in relation to survival gains, the resulting cost-effectiveness ratios are on average, above $200,000 per life year gained [4]. Even dramatic increases in cancer drug costs will have little impact on total health expenditures in the foreseen future. At least in countries with generous public health insurance coverage total expenditures for cancer drugs still seem affordable. The contrast between high prices and relatively low budget impact has led to diverging recommendations by experts and policymakers in countries with generous public health insurance coverage, ranging from ‘wait and see’ to considerable price cuts [7]. Health care systems around the world struggle with high prices for new cancer drugs. The cure was hypothesized to arrive in incremental steps but at infinitesimally small time intervals (resulting, effectively, in an immediate cure)
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
