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Physician Groups Question Cancer Drugs’ Values

Pharmaceuticals: Costs, risks, and benefits of cancer drugs come under renewed scrutiny

by Ann M. Thayer
June 29, 2015 | A version of this story appeared in Volume 93, Issue 26

With global spending on cancer drugs topping $100 billion in 2014, doctors, increasingly alarmed by the cost of the treatments, are attempting to calculate the true values of individual drugs by accounting for all of their risks and benefits.

Drugs to treat hematologic cancers offer better outcomes—at a price. SOURCE: Cancer 2015, DOI: 10.1002/cncr.29512
Bar graph showing annual costs to a patient of certain cancer drugs in the U.S.
Drugs to treat hematologic cancers offer better outcomes—at a price. SOURCE: Cancer 2015, DOI: 10.1002/cncr.29512

Last week, the American Society of Clinical Oncology proposed a tool for determining the value of new cancer treatments (J. Clin. Oncol. 2015, DOI: 10.1200/jco.2015.61.6706). ASCO hopes to help doctors evaluate outcomes, side effects, and costs to determine a “net health benefit” and choose the best therapy options.

About a month earlier, the European Society for Medical Oncology launched a similar tool (Ann. Oncol. 2015, DOI:10.1093/annonc/mdv249).

Despite substantial improvements in care, patients and insurers are being challenged by rising costs—the price of many cancer therapies now tops $10,000 per month. “It’s critical to distinguish between value and cost,” says Lowell E. Schnipper, chair of ASCO’s Value in Cancer Care Task Force. ASCO is accepting comments regarding its calculator via its website through Aug. 21.

In response, Pharmaceutical Research & Manufacturers of America (PhRMA), a drug industry trade group, says it “appreciates ASCO’s efforts to develop a new tool to support informed decision-making” but stresses that such decisions “are highly individualized and vary over time as new research and treatment options emerge.”

The consulting firm Boston Healthcare released a PhRMA-commissioned report supporting the industry view. Whereas the ASCO tool relies on clinical trial data, the PhRMA report asserts that the “full therapeutic value of a cancer therapy is typically realized long after the drug’s initial FDA approval.”

Meanwhile, major medical groups are entering the discussion. Earlier this month, Memorial Sloan Kettering Cancer Center in New York posted its online DrugAbacus for comparing costs of drugs while considering side effects, patient outcomes, and R&D factors. And doctors at the University of Texas MD Anderson Cancer Center have reanalyzed data from 20 studies of nine hematologic cancer treatments, concluding that prices for most of them are too high to be cost-effective (Cancer 2015, DOI: 10.1002/cncr.29512).



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