2020/02/26 Cancer drug costs out of control

Cancer drug costs out of control

Nature Reviews Drug Discovery 10, 801 (November 2011)

Reforms are needed to curb the rising costs of cancer treatment, finds a detailed review by The Lancet Oncology commission.

The lowdown: In an attempt to tackle the spiralling costs of cancer care, 37 members of the cancer community, including clinicians, economists, academics and patient advocates, compiled a 48-page report on the problem (Lancet Oncol. 12, 933–980; 2011). They report that the total cost of care in the United States in 2010 was $124 billion, roughly 5% of the total health-care spending, in line with other surveyed countries in which it ranged from 4.1% to 9.3%. The report notes that the cost of a systemic therapy in the United Kingdom has risen from 34% of per capita gross domestic product in 1995 to 67% in 2009, and points to new agents costing over $100,000 per treatment course as evidence that costs are likely to continue to rise.

The commission concedes that high research and development (R&D) costs and limited patient populations largely explain the high costs of new drugs, though it adds that overutilization, consumer demand and futile care are also key drivers. Yet, citing the marginal efficacy of many new products, it nevertheless proposes broad strategies to bring the prices to heel. “Urgent solutions range from re-engineering of the macroeconomic basis of cancer costs (for example, value-based approaches to bend the cost curve and allow cost-saving technologies), greater education of policy makers, and an informed and transparent regulatory system.”

In an associated comment article, National Institute for Health and Clinical Excellence (NICE) officials argue that drug makers can reduce clinical trial costs by up to 60% by adopting measures including electronic data capture and adaptive trial design (Lancet Oncol. 12, 931–932; 2011). European Medicines Agency officials added separately that regulators and payers could work towards agreeing on pre-marketing and post-marketing evidentiary standards for relative effectiveness and could provide joint guidance on clinical development to reduce R&D costs (Lancet Oncol. 12, 930–931; 2011).