Cancer research is not at all cost effective. While over five million Americans might die of cancer every year, it would cost $440 billion to extend life by one year, it has been estimated.
Researchers from the National Cancer Institute and National Institutes of Health, say that 90% of cancer drugs approved in the past four years cost more than $20,000 for 12 weeks worth of treatment.
The spiraling cost of cancer care, in particular the cost of
cancer therapeutics that achieve only marginal benefits, is
under increasing scrutiny, they said a new article in the Journal of the National Cancer Institute.
Although health-care professionals
avoid putting a value on a life, our limited resources require
that society address what counts as a benefit, the extent to
which cost should factor in deliberations, and who should be
involved in these decisions.
Professional societies, such as
the American Society of Clinical Oncology, government agencies,
including the Food and Drug Administration, and insurance companiesshould be involved. However, no segment of society is better
qualified to address these issues than the oncology community.
Oncologists must offer clear guidance for the conduct of research, interpretation of results, and prescription of chemotherapies.
We review recent drug approvals and clinical trials and comment
on their relevance to the issue of the spiraling cost of oncology
therapeutics. We suggest some standards that would serve as
a starting point for addressing these issues.
Some drugs have limited upsides, and these shouldn't be developed unless they will cost patients less than $20,000 for a standard course, they say. Two more recommendations from the authors: doctors shouldn't prescribe cancer medicines for non-approved purposes, and new medicines with marginal benefits shouldn't be used for those with advanced cancer.
Treating lung-cancer with Erbitux, a Bristol-Myers and Eli Lilly drug, costs $80,000 for an 18-week regimen but extends life by only 1.2 months, the authors estimate. Bristol-Myers says the real-world cost number of Erbitux is closer to $10,000 a month. Drug makers say the cost estimates are often exaggerated because most patients are only on them for limited amounts of time and many received financial assistance, according to the Wall Street Journal.
So the challenge is this: How to develop new medicines — especially those that might help certain individuals a lot even if the benefit to patients as a group isn't impressive — while trying to keep costs in check.
Eric Winer, chief scientific adviser to Susan G. Komen for the Cure, a breast-cancer advocacy group, conceded expensive research with limited impact on the community should not be encouraged beyond a point.
But, he cautioned, "We have to be careful not to slow down the process of drug development. Ultimately it is medical therapy that will make a huge difference in people's lives."