High prices of cancer drugs is affecting patient care in the US and the American health care system overall, suggested the authors of a special article appearing online in the journal 'Mayo Clinic Proceedings'. Study authors S. Vincent Rajkumar, M.D., of Mayo Clinic Cancer Center and his colleague, Hagop Kantarjian, M.D., of MD Anderson Cancer Center, revealed that the average price of cancer drugs for about a year of therapy increased from $5,000 to $10,000 before 2000 to more than $100,000 by 2012. Whereas, the average household income in the U.S. decreased by about 8% over nearly the same period.
"Americans with cancer pay 50 percent to 100 percent more for the same patented drug than patients in other countries. As oncologists we have a moral obligation to advocate for affordable cancer drugs for our patients," said Dr. Rajkumar.
AdvertisementIn the study paper, the authors rebut the major arguments the pharmaceutical industry uses to justify the high price of cancer drugs, namely, the expense of conducting research and drug development, the comparative benefits to patients, that market forces will settle prices to reasonable levels, and that price controls on cancer drugs will stifle innovation. Dr. Rajkumar and Dr. Kantarjian say other reasons for the high cost of cancer drugs include legislation that prevents Medicare from being able to negotiate drug prices and a lack of value- based pricing, which ties the cost of a drug to its relative effectiveness compared to other drugs.
Dr. Rajkumar said, "One of the facts that people do not realize is that cancer drugs for the most part are not operating under a free market economy. The fact that there are five approved drugs to treat an incurable cancer does not mean there is competition. Typically, the standard of care is that each drug is used sequentially or in combination, so that each new drug represents a monopoly with exclusivity granted by patent protection for many years."
The authors recommend a set of potential solutions to help control and reduce the high cost of cancer drugs in the US. Some of their recommendations which are already in practice in other developed countries include-
1. Medicare should be allowed to negotiate drug prices.
2. Cancer treatment pathways/guidelines that incorporate the cost and benefit of cancer drugs should be developed.
3. The Food and Drug Administration or physician panels should be allowed to recommend target prices based on a drug's magnitude of benefit (value-based pricing).
4. Eliminate 'pay-for-delay' strategies in which a pharmaceutical company with a brand name drug has to share profits on that drug with a generic drug manufacturer for the remainder of a patent period, effectively eliminating a patent challenge and competition.
5. Import of drugs from abroad for personal use should be allowed.
6. Patient-Centered Outcomes Research Institute and other cancer advocacy groups should be allowed to consider cost in their recommendations.
7. Patient-driven grassroots movements and organizations should be created to advocate effectively for the interests of patients with cancer to balance advocacy efforts of pharmaceutical companies, insurance companies, pharmacy outlets and hospitals.