November 07, 2014
Dealing with the high cost of cancer drugs
BY MD Anderson staff
"The only drug that works is a drug that a patient can afford."
That's what Hagop Kantarjian, M.D., told "60 Minutes" correspondent Leslie Stahl in a report titled "The Cost of Cancer Drugs," which aired recently on the CBS news magazine.
Kantarjian, who is chair of Leukemia at MD Anderson, has been a vocal proponent of affordable cancer drugs for some time. In an effort to spotlight the issue, he and more than 100 chronic myeloid leukemia (CML) experts collaborated on an opinion piece for the hematology journal Blood in 2013 that focused specifically on the cost of approved tyrosine kinase inhibitors.
In that article, the authors proposed that the cost of cancer drugs should reflect the "just" price or fair value, not what a person would be willing to pay. They compared a just price to "the price of bread during famines, polio vaccine, ivermectin for river blindness (provided free by Merck and estimated to have saved the vision of 30 million individuals), and treatments of chronic medical conditions (cardiovascular, hypertension, diabetes, tuberculosis, multiple sclerosis, etc)."
On "60 Minutes," Kantarjian spoke to Stahl about the cost of the CML drug Gleevec, a tyrosine kinase inhibitor that extends the lives of most patients by 10 or more years.
"... Here you have a drug that makes people live their normal life," he said. "But in order to live normally, they are enslaved by the cost of the drug. They have to pay every year."
Writing in the Journal of Oncology Practice earlier this year, Kantarjian spelled out the reasons for, and proposed solutions to, the high and rising price of cancer drugs in the U.S.
The prices of patented cancer drugs in the United States have increased 5- to 10-fold from before 2000 until now, and the cost of new drugs continues to grow far ahead of inflation. The average cancer drug price for approximately 1 year of therapy or a total treatment duration was less than $10,000 before 2000, and had increased to $30,000 to $50,000 by 2005. In 2012, 12 of the 13 new drugs approved for cancer indications were priced above $100,000 per year of therapy.
Among the solutions he suggested to help lower costs were:
Reviewing and reducing the research bureaucracy and burdens could eliminate unnecessary steps that increase cost, delay timelines, and shorten drug patent times. Allowing Medicare to negotiate drug prices, eliminating pay-for-delay strategies, allowing importation of drugs from abroad for personal use ... . Professional societies representing cancer specialists and advocating for cancer patients should be involved in reducing the hype around new cancer drugs that do not have a major impact on patient outcomes.
A disease as widespread as cancer affects almost everyone in the U.S., either directly or indirectly. And ultimately, for Kantarjian and other doctors, the bottom line is patient care.
"High cancer drug prices are harming patients because either you come up with the money, or you die."