Cost Of Cancer Drugs Research Articles

1K4Cancer Breaks the Silence: A Crowd-Funding Campaign by Sebeccly Cancer Care

Amount raised: The 1K4Cancer campaign raised a total of $18,099. Background and context: Poverty, chronicity of spending, paying out-of-pocket for health care needs, and the prohibitive cost of cancer drugs are some of the reasons cancer patients don't start or complete treatment. Over 90% of Nigerian cancer patients pay for healthcare expenses out-of-pocket; putting a heavy strain on their finances and those of their caregivers. Sebeccly is a cancer charity that enables cancer care access to indigent cancer patients through several fundraising modalities, one of which is the 1K4Cancer. The campaign is a cancer drug fund and crowd fundraiser that appeals for a minimum donation worth $2.50. Launched in October 2012 (for 3 months), and relaunched in March 2018, 1K4Cancer provides treatment aid to breast cancer patients. Aim: To raise funds and provide access to cancer care to indigent breast cancer patients. Strategy/Tactics: The 1K4Cancer campaign reaches out to individuals/organizations by leveraging on social media, relationship management with donors and several 1K4Cancer ambassadors to engage networks to raise funds to support cancer treatment and screening services. This strategy has an online and offline component, with the offline driving the online component. Program process: The 1K4Cancer runs under 7 broad categories: Community events: Focus on advocacy and education on cancer prevention and early detection. Health talks and the 1K4Cancer appeal are delivered during community outreaches. Online community engagements: partnerships with online blogs and influencers to promote the campaign were secured. The social media community was engaged in heartwarming messages and call-to-action statements to support indigent cancer patients. Media partnership: partnerships with online and traditional media houses were secured. The 1K4Cancer message was published on several eminent blogs. Relationship management with donors: past and prospective donors were engaged to promote the campaign. 1K4Cancer remains transparent and accountable through an online monthly newsletter. Donation collection: donations were made through online bank transfer and Sebeccly's online donation platforms. Volunteers: recruitment of 1K4Cancer volunteers who helped to promote and create more awareness about the campaign offline. Partnerships with hospitals: the beneficiaries of the campaign receive cancer care at Lagos University Teaching Hospital, and Lagos State University Teaching Hospital. Costs and returns: $2715 has been spent on online adverts, branding materials, creatives, publications, administrative charges, and logistics. Total returns so far: $15,384. What was learned: Leveraging on goodwill, accountability, the Internet, and a compelling story are necessary ingredients to a crowd-funding campaign. The 1K4Cancer is an innovative crowd-funding campaign that relieves the financial burden of cancer patients and help achieve access to quality cancer care.

Gastrointestinal (GI) cancer (CA) drugs approved by the US Food and Drug Administration (FDA): Clinical value and cost considerations.

6619Background: The mounting cost of CA drugs has presented significant financial toxicity to all stakeholders over recent years. We aimed to assess the clinical value and cost of GI CA drugs appro...

Value and Cost of Myeloma Therapy.

Major advances have occurred in the treatment of multiple myeloma, including several new drugs that typically cost more than $100,000 per year. Although the gains in myeloma therapy improve overall survival considerably, they are available to only a fraction of the population of patients with myeloma in the world because of regulatory barriers and cost. Myeloma is an example of what is happening in cancer on a much larger scale. Many of the problems discussed call for a wider discussion across all cancers, but they are amplified in myeloma because of the need for multidrug regimens that combine three or more expensive new drugs for prolonged periods of time. In this article, the reasons for the high cost of cancer drugs and possible solutions are examined. The lack of correlation of value and price, the remarkable rise in prices of existing old medications over time, and the lack of access to lifesaving drugs across various countries are also discussed.

Nursing : 7 key cancer trends

Cancer is a generic term used to describe a disorder in cellular growth and refers to a range of diseases and not to a single entity. Because cancer is a cellular disease, it can arise from any body tissue, with manifestations that result from failure to control the proliferation and maturation of cells. An oncology nurse provides care for cancer patients and patients at risk. They monitor physical conditions, prescribe drugs, administer chemotherapy and other treatments. Current trends in oncology emerging areas of health care, such as informatics, have been identified as well as opportunities for nursing professionals to be at the forefront of transforming cancer care. Some basics of advanced nursing practice, including cancer screening, prevention, early detection, genetic risk, cancer diagnosis and progression, and all the way to cancer survival. Nurses have a wide range of responsibilities to deal with a cancer patient. Nursing care includes assessment, support for treatments (eg, chemotherapy, radiation, etc.), pain control, nutrition enhancement, and emotional support. The aim of this review is to discuss the nursing and 7 key cancer trend which includes: less chemotherapy, more prescriptions of novel anti-cancer agents, concern over cancer drug costs, focus on diagnostics, quality and payment for genetic cancer tests, tumor-agnostic prescribing of cancer medications, patient-reported outcomes, and artificial intelligence.

Evidence on the cost of breast cancer drugs is required for rational decision making.

BackgroundFor rational decision making, assessing the cost-effectiveness and budget impact of new drugs and comparing the costs of drugs already on the market is required. In addition to value frameworks, such as the American Society of Clinical Oncology Value Framework and the European Society of Medical Oncology–Magnitude of Clinical benefit Scale, this also requires a transparent overview of actual drug prices. While list prices are available, evidence on treatment cost is not. This paper aims to synthesise evidence on the reimbursement and costs of high-cost breast cancer drugs in The Netherlands (NL).MethodsA literature review was performed to identify currently reimbursed breast cancer drugs in the NL. Treatment costs were determined by multiplying list prices with the average length of treatment and dosing schedule.ResultsComparing list prices to the estimated treatment cost resulted in substantial differences in the ranking of costliness of the drugs. The average mean treatment length was unknown for 11/31 breast cancer drugs (26.2%). The differences in the 15 highest-cost drugs were largest for Bevacizumab, Lapatinib and everolimus, with list prices of €541, €158, €1,168 and estimated treatment cost of €174,400, €18,682 and €31,207, respectively. The lowest-cost (patented) targeted drug is €1,818 more expensive than the highest-cost (off-patent) generic drug according to the estimated drug treatment cost.ConclusionsA lack of evidence on the reimbursement and cost of high-cost breast cancer drugs complicates rapid and transparent evidence synthesis, necessary to focus strategies aiming to limit the increasing healthcare costs. Interestingly, the findings show that off-patent generics (such as paclitaxel or doxorubicin), although substantially cheaper than patented drugs, are still relatively costly. Extending standardisation and increasing European and national regulations on presenting information on costs per cancer drug is highly recommended.

Affordability and Price Increases of New Cancer Drugs in Clinical Guidelines, 2007-2016.

In response to the rising cost of cancer drugs, the National Comprehensive Cancer Network (NCCN) recently developed a value framework, known as “Evidence Blocks,” to grade the efficacy, safety, evidence quality, evidence consistency, and affordability of treatments included in its clinical guidelines. The value scores were available for 55 of the 69 new cancer drugs approved by the US Food and Drug Administration from 2007 to 2016. Overall, the treatment costs for 95% of new cancer medicines in NCCN clinical guidelines were scored as “very expensive” or “expensive”. In multivariable ordered logistic regression models, there was no association between the affordability of new cancer drugs and efficacy and safety data available in clinical guidelines. Most guideline-recommended drugs were subject to annual list price increases exceeding inflation.

Sticker shock.

A data-savvy doctor speaks out about cancer drug costs.

Application of the ASCO Value Framework and ESMO Magnitude of Clinical Benefit Scale to assess the value of abiraterone acetate (AA) and enzalutamide (E) in advanced prostate cancer: clinical value and cost considerations.

276 Background: AA and E improve overall survival (OS) in metastatic castration resistant prostate cancer (mCRPC). AA also improves OS in metastatic castration sensitive disease (mCSPC). However, concerns exist over the cost implications of earlier treatment versus the clinical benefit gained. We aimed to quantify and compare the clinical value of AA and E and their drug costs in both the mCRPC and mCSPC settings. Methods: We identified 6 randomized Phase 3 trials of AA and E in mCRPC and mCSPC. Net clinical benefit was quantified by the ASCO Value Framework version 2 (range < 180) and ESMO MCBS version 1.1 (range 1-5)—both consider benefits in overall survival, progression free survival, and quality of life, against increase in drug toxicity. A higher score indicates greater value. Incremental cancer drug costs were also calculated, using average wholesale price from the REDBOOK and the trials’ reported duration of treatment. Results: (Table). Conclusions: AA and E administered in early mCSPC do not provide consistent increases in net clinical benefit compared to mCRPC, but they incur exponential cost considerations. Alternatives such as chemotherapy, which may provide similar net clinical benefit at less incremental costs, still warrant major consideration for clinicians and patients. Until more information is available to define the optimal sequencing of AA, E and other available treatment modalities, current cost implications may hinder moving these agents to earlier treatment settings.[Table: see text]

Methodology to Forecast Volume and Cost of Cancer Drugs in Low- and Middle-Income Countries.

PurposeIn low- and middle-income countries (LMICs), frequent outages of the stock of cancer drugs undermine cancer care delivery and are potentially fatal for patients with cancer. The aim of this study is to describe a methodologic approach to forecast chemotherapy volume and estimate cost that can be readily updated and applied in most LMICs.MethodsPrerequisite data for forecasting are population-based incidence data and cost estimates per unit of drug to be ordered. We used the supplementary guidelines from the WHO list of essential medicines for cancer to predict treatment plans and ordering patterns. We used de-identified aggregate data from the Botswana National Cancer Registry to estimate incident cases. The WHO Management Sciences for Health International Price Indicator was used to estimate unit costs per drug.ResultsChemotherapy volume required for incident cancer cases was estimated as the product of the standardized dose required to complete a full treatment regimen per patient, with a given cancer diagnosis and stage, multiplied by the total number of incident cancer cases with the respective diagnosis. The estimated chemotherapy costs to treat the 10 most common cancers in the public health care sector of Botswana is approximately 2.3 million US dollars. An estimated 66% of the budget is allocated to costs of rituximab and trastuzumab alone, which are used by approximately 10% of the cancer population.ConclusionThis method provides a reproducible approach to forecast chemotherapy volume and cost in LMICs. The chemotherapy volume and cost outputs of this methodology provide key stakeholders with valuable information that can guide budget estimation, resource allocation, and drug-price negotiations for cancer treatment. Ultimately, this will minimize drug shortages or outages and reduce potential loss of lives that result from an erratic drug supply.

Availability of WHO Essential Medicines for Cancer Treatment in Botswana.

PurposeStock outs of cancer drugs are potentially fatal but have not been systematically studied in low- and middle-income countries. The aim of this study was to determine the availability and alignment of the Botswana National Essential Medicines List (NEML) for cancer drugs with the WHO’s Essential Medicines List (EML).MethodsThe availability and cost of cancer drugs were analyzed using data from a weekly stock catalog sent by Botswana’s Central Medical Store to all pharmacy departments in government hospitals. Comparative data were extracted from the WHO EML and the “International Drug Price Indicator Guide-2014” from the Management Sciences for Health. Interviews with key informants were used to collect data on the Botswana NEML and the drug supply chain in the public sector.ResultsThe 2015 Botswana NEML for cancer had 80.5% alignment with the WHO EML. At least 40% of essential drugs were out of stock for a median duration of 30 days in 2015. Stock outs affected chemotherapy drugs included in first-line regimens for treating potentially curable diseases such as cervical, breast, and colorectal cancer and were not associated with buyer price of therapy. Analyses showed that the median price ratio for procured drugs was greater than 1 for 61% of the NEML drugs, which suggests inefficiency in procurement in the public sector.ConclusionsBotswana has one of the highest alignments of NEML to the WHO EML in the sub-Saharan African region, which is consistent with investment in the health care system evident in other clinical spheres. Better quantification of chemotherapy requirements using data from the National Cancer Registry and resource-sensitive treatment guidelines can help reduce stock outs and facilitate more effective and efficient procurement processes.

BIOBOARD

ASIA – Scientists create successful mass production system for bioengineered livers OCEANIA – Researcher looks to next generation antibody treatment for chronic kidney disease AMERICAS – United States cancer drug costs increasing despite competition AMERICAS – Eating yogurt may help reduce chronic inflammation in women AMERICAS – Forget calorie counting

Costs of injectable cancer drugs increase after launch in USA

Costs of injectable cancer drugs increase after launch in USA

Trajectories of Injectable Cancer Drug Costs After Launch in the United States.

Purpose Cancer drug prices at launch have increased in recent years. It is unclear how individual drug prices change over time after launch and what market determinants influence these changes. We measured the price trajectories of a cohort of cancer drugs after their launch into the US market and assessed the influence of market structure on price changes. Methods We studied the changes in mean monthly costs for a cohort of 24 patented, injectable anticancer drugs that were approved by the US Food and Drug Administration between 1996 and 2012. To account for discounts and rebates, we used the average sales prices published by the Centers for Medicare and Medicaid Services. Costs were adjusted to US general and health-related inflation rates. For each drug, we calculated the cumulative and annual drug cost changes. We then used a multivariable regression model to evaluate the association between market and cost changes over time. Results With a mean follow-up period of 8 years, the mean percent change in cost for all drugs was +25% (range, -14% to +96%). After adjusting for inflation, the mean cost change was +18% (range, -16% to +59%). Rituximab and trastuzumab followed a similar pattern in cost increases over time, and the inflation-adjusted monthly costs rose since approval by 49% and 44%, respectively. New supplemental US Food and Drug Administration approvals, new off-label indications, and new competitors did not influence the annual cost change rates. Conclusion Anticancer drug costs may change substantially after launch. Regardless of competition or supplemental indications, there is a steady increase in costs of patented anticancer agents over time. New regulations may be needed to prevent additional increases in drug costs after launch.

Real-World Data Analysis of Cancer Treatment Cost Drivers By Type and Place of Service

As the US healthcare system transitions from one of volume based delivery to one focused on quality and value there is a continued focus on understanding the drivers of cost, especially in oncology. Cancer drug costs have been a focus of much debate and this study analyzes real world data from two large volume cancer centers in the US to quantify drivers of cancer treatment costs. Integra Connect utilized Medicare claims data from two large cancer treatment centers in the US with over 60,000 cancer patients treated in the last 12 months. Overall treatment costs were categorized into 9 cost buckets (including Part B drug costs, Part D drug costs, Inpatient, E&M, Lab testing, Imaging, Emergency visits, etc.). Treatment costs were based on amounts paid by CMS from July 2016 through August 2016. Secondary research included a review of previously published studies on cost drivers of cancer care for comparison to current results. Our research found that prescription drug costs from both Part B and Part D paid Medicare claims accounted for 47% (site 1) and 51% (site 2) of total cancer treatment costs. Second to cancer treatment costs, inpatient hospitalization related costs accounted for 20% (site 1) and 17% (site 2) of overall costs. These results contrast previously published research that found cancer drug costs to be a smaller proportion of overall treatment costs (18% of overall costs attributed to chemotherapy and other cancer drugs)1. This real-world data analysis highlights the variability in cancer treatment costs and the continued need for cancer treatments to demonstrate value and savings among other areas that drive overall cost. 1“Cost Drivers of Cancer Care: A Retrospective Analysis of Medicare and Commercially Insured Population Claim Data 2004-2014”, Milliman

Estimating The Drug Treatment Cost of Breast Cancer

Objectives Overall treatment costs in oncology are increasing rapidly due to the increasing availability of expensive drugs. Comparing the costs of currently used drugs and assessing the cost-effectiveness of new drugs requires a transparent overview of actual breast cancer treatment prices. As such an overview is lacking, this study aims to synthesize evidence on the reimbursement and costs to estimate the total treatment cost of expensive breast cancer drugs for the Netherlands. Methods Evidence on the approval, reimbursement and list prices of expensive breast cancer drugs was identified from the Dutch Administrative Health Authority (ZINL). Data on the average length of treatment and dosing schedules was obtained from European Parliament Assessment Reports (EPARs) or ZINL reports. All evidence was aggregated in the estimation of actual treatment cost. Results In the Netherlands, 31 breast cancer drugs are approved (available in 41 different forms). Based on drug list prices Pertuzumab, Trastuzumab Emtansine and Trastuzumab are the most expensive drugs. For 17/41 (41.5%), no evidence on the average treatment length was available in EPARs or ZINL reports. Comparing list prices to the estimated treatment cost per patient resulted in substantial differences in the ranking of expensiveness of the drugs. Overall, estimated treatment costs were highest for Bevacizumab, Pertuzumab and Trastuzumab Emtansine. Conclusions Estimating treatment costs is far from trivial, given the wide range of evidence sources that need to be synthesized. This complicates rapid and transparent assessment of actual cancer drug treatment cost, which is necessary to focus strategies aiming to limit the increasing healthcare costs. Differences exist in list prices within countries and between countries, thereby influencing the corresponding estimated treatment costs and resulting in list prices having limited value in this context. Therefore, extending standardization in presenting information on costs per cancer drug and implementing real world price estimates in such calculations is highly recommended.

1123P - The cost of expensive breast cancer drugs

Background: Increasing healthcare costs are a major challenge in medical oncology, since the total costs of oncology can account for up to 30% of the total hospital expenditures. As many novel (expensive) cancer treatments are being developed, it is important to be transparent about drug prices from an early research stage on. To assess the potential financial impact of pipeline drugs, their expected future prices can be deducted from prices of currently used drugs. As an overview of the standard prices of expensive breast cancer treatments in European countries is lacking, this review aimed to synthesize all evidence on costs of approved, expensive breast cancer drugs in the Netherlands. Methods: A literature review was performed to create an overview of all approved, expensive drugs in the Netherlands. Standard drug costs were retrieved via the Dutch administrative health authority (ZINL). Drugs were considered expensive if the standard price of the drug was more than €10 per unit or if the cost of a treatment with that particular drug exceeded €1000 on average per patient. Results: In the Netherlands 25 breast cancer drugs are approved with a standard price of more than €10 per unit. After excluding drugs with expected treatment costs less than €1000, 19 drugs were included in the analysis. The standard drug price is €7,943 on average (range €63 - €45,452), and the average number of cycles per patient is 10.5 (range 4 - 25.3 cycles). This results in average treatment costs per patient of expensive drugs of €17,968 (range €1,103 - €87,123). Four drugs that initially ranked low based on standard drug unit prices (rank 10-19), rank substantially higher (rank 1-10) when ranking total treatment costs. Conclusions: Ranking standard drug prices per unit may not be very informative. It would be valuable to rank drug treatment costs, based on treatment length and dosage estimates. However, in the Netherlands the expected treatment length for a particular drug is not standardly reported in official approval reports. Furthermore, actual prices of expensive drugs may differ from standard drug prices, by which treatment costs might be deviant. Extending standardization of reporting and calculation of drug treatment costs would be valuable and particularly relevant when extending this type of cost calculations to other countries. Legal entity responsible for the study: University of Twente - Health Technology and Services Research Funding: None Disclosure: All authors have declared no conflicts of interest.

Pharmaceutical assistance programs for cancer patients in the era of orally administered chemotherapeutics.

Introduction The rising cost of cancer drugs may make treatment unaffordable for some patients. Patients often rely on drug manufacturer-administered Pharmaceutical Assistance Programs (PAPs) to obtain drugs and reduced or no cost. The overall usage of PAPs within cancer care delivery is unknown. Methods We included all cancer patients across an academically affiliated, integrated health system in North Carolina during 2014 ( N = 8591). We identified the subset of patients receiving PAP assistance to afford one or more cancer drugs, in order to calculate the proportion of patients receiving PAP assistance, and the retail value of the assistance. Results Among 8591 cancer patients, 215 unique patients submitted a total of 478 successful PAP requests for cancer drugs. 40% of PAP-utilizing patients were uninsured, 23% had Medicaid coverage, 20% had Medicare coverage, 2% were dual Medicare/Medicaid eligible, and 14% were commercially insured. Among all cancer patients who received medical treatment, 6.0% required PAP assistance, whereas 10.6% receiving an oral agent required PAP assistance. The proportion receiving PAP assistance varied substantially by drug, ranging from <1% of patients (e.g. carboplatin, methotrexate) to 50% of patients (e.g. ponatinib, temsirolimus). The majority of the retail value obtained was for oral agents, including $1,556,575 of imatinib and $1,449,633 of dasatinib, which were the two drugs with the highest aggregate retail value. Conclusions A substantial proportion of cancer patients receive private charitable assistance to obtain standard-of-care treatments. This includes patients with federal and private insurance, suggesting an inability of patients to meet cost-sharing requirements.

The Cost of Oncology Medicines

Abstract Cancer as a financial value is one of the most expensive diseases. Costs, including the cost of new cancer drugs, are increasing at an unsustainable rate, threatening the permanent access of patients to treatment. Prices for new treatments against cancer have doubled over the past 10 years and now are usually between USD 6000 and USD 10,000 per month, this increase is often not correlated with reimbursement and implemented public health benefits. According to various authors, these results lead to debate whether the cost differences between EU countries and the US for the treatment of oncologic diseases are transformed into improved outcomes for patients, and must also take into account key factors such as lifestyle, late diagnosis, and management approach for treatment, reimbursement of oncology treatment and control of various institutions on spending.

Pharmaceutical assistance foundations in the financing of cancer care.

8 Background: The rising cost of cancer drugs may make treatment unaffordable for some patients. Patients often rely on drug manufacturer-administered Pharmaceutical Assistance Programs (PAPs) to obtain drugs at reduced or no cost. The overall impact of PAPs on cancer care delivery is unknown. Methods: We identified all patients obtaining cancer drugs across an academically affiliated, integrated health system in the state of North Carolina during 2014. The proportion of patients receiving PAP assistance, and the retail value of the assistance, were quantified for each oncology drug. Cancer drugs were analyzed with respect to route of administration. Results: 215 unique patients submitted a total of 478 successful PAP requests for cancer drugs. The majority of the retail value of drugs obtained was for oral cancer drugs, particularly targeted therapies including tyrosine kinase inhibitors. Among all cancer patients who received medical treatment, 5.5% required PAP assistance, whereas 10.6% receiving an oral agent required PAP assistance (Table). The proportion receiving PAP assistance varied substantially by drug, ranging from &lt;1% of patients (e.g., carboplatin, methotrexate) to 50% of patients (e.g., ponatinib, temsirolimus). Patients obtained a total of $1,556,575 of imatinib and $1,449,633 of dasatinib, which were the two drugs with the highest aggregate retail value. 40% of PAP-utilizing patients were uninsured, 26% had Medicaid coverage, 20% had Medicare coverage, and 14% were commercially insured. Conclusions: A substantial proportion of patients with cancer receive private charitable assistance through PAPs in order to obtain standard-of-care treatments. In particular, a disproportionate share of patients treated with orally-available cancer drugs require PAP assistance. This includes patients with federal and private insurance, suggesting an inability of patients to meet cost-sharing requirements. [Table: see text]

Safety of Cancer Therapies: At What Cost?

The cost of cancer drugs has increased concurrently with drug safety resulting in both increased survivorship and increased out-of-pocket costs and co-payments for patients. This article evaluates the interplay between patient safety and cancer drug costs to determine how cancer drug costs affect patient safety and well-being. A literature review was performed that identified the main drivers of drug safety costs: drug-drug interactions, adverse drug events, medication errors, and nonadherence. Three main types of costs were identified: out-of-pocket spending, drug cost growth, and safety-related costs. Insured patients receiving chemotherapy pay an average of $10,000/month on out-of-pocket expenses. Annual drug cost growth has been as much as 21% in recent years. Over a span of 13 years, 1999-2013, insurance premiums and out-of-pocket payments have increased by 182% and 200%, respectively. Safety-related concerns include the high cost of developing a new drug, estimated at $5 billion. The cost of development is reflected in the cost of the 12 new cancer drugs that received Food and Drug Administration approval in 2012; 11 were priced at 6 figures. Although advances in pharmaceutical technology and research have yielded effective cancer therapies that reduce physical or treatment-related toxicity, patients have had to face worsening financial uncertainty both during and after treatment. Actions are needed to achieve financial safety, as well as therapeutic and clinical safety, for cancer patients.