No doubt about it--cancer drugs are hot. With new targeted therapies coming online--and immunotherapies the talk of this year's ASCO meeting--oncologists are getting new treatments for their tool chests, and drugmakers are adding lucrative products to their cash boxes.
But there's a hitch: cost. These new cancer therapies are potentially lucrative because they're pricey. Some recent rollouts top $100,000 per year, with upper-6-figure prices for the rest. The highly anticipated immunotherapies are expected to run around $110,000 in the U.S., analysts tell Reuters, with $80,000 price tags common in the rest of the world.
So, experts say, cancer care will have to change. In fact, it already has. One recently launched cancer drug, Sanofi's ($SNY) Zaltrap, was immediately discounted after Memorial Sloan-Kettering doctors decided its benefits weren't worth the price of about $10,000 per month. The top cancer hospital may do the same for other pricey drugs, doctors said. Meanwhile, insurers are prereviewing drug therapies more often, and they're less inclined to approve off-label use. And as Reuters notes, some 80% of U.S. insurers told PricewaterhouseCoopers they won't add new therapies to their formularies without evidence of cost savings and clinical benefits.
Patients are shouldering more of the cost burden, with 20% co-pays amounting to tens of thousands in some cases. And as one oncologist told Reuters, patients may soon be required to pay a higher share for drugs whose proven survival benefits are on the low end. "There will be increased cost-sharing for patients based on the relative value of a particular therapy," Dr. Neal Meropol of the University Hospitals Case Medical Center in Cleveland told Reuters.
So doctors and patients will have to get over their squeamishness about talking about the cost of cancer care. A study released at ASCO showed only 19% of patients have the "money talk" with their doctors, even though a much higher percentage want to. And drugmakers, already asked to make their case for payers, will have to pony up even more information and cost analysis to get on the right lists. They might have to negotiate bigger discounts, too, and not just with government watchdogs like the U.K.'s National Center for Health and Care Excellence.
There are hopes that some new meds will end up saving money in the long run. Just as diabetes drugs can prevent costly complications and blood thinners and cardiovascular meds help stave off heart attacks and strokes, powerful cancer treatments administered early in the illness might help save money on costly, pull-out-the-stops care in later stages of the disease. "Even if it looks like we're developing expensive agents, these will eventually be cheap, because it's actually treating people," UCLA Jonsson Comprehensive Cancer Center's Dr. Antoni Ribas told the news service.
- see the Reuters analysis
Special Report: Zaltrap (aflibercept concentrate) - Top 10 Late-Stage Cancer Drugs – 2012