Oncologists Demand Action against Rising Cancer Drug Prices

A group of 118 oncologists have called for measures to stop escalating cancer drug prices, adding their voices to those of other doctors and patient advocates who have demanded action in recent years.

In a commentary to be published today in the journal Mayo Clinic Proceedings, the oncologists said they were responding to drug expenses that have zoomed up to 10-fold over a 15-year period ending in 2012, to more than $100,000 a year. For some of the newest immunotherapies, the cancer doctors added, annual costs approach $150,000.

“When you consider that cancer will affect 1 in 3 individuals over their lifetime, and [with] recent trends in insurance coverage [that] put a heavy financial burden on patients with out-of-pocket expenses, you quickly see that the situation is not sustainable,” the commentary’s lead author Ayalew Tefferi, M.D., a hematologist at Mayo Clinic., said in a statement. “It’s time for patients and their physicians to call for change.”

The oncologists also cited a study by David H. Howard, Ph.D., of Emory University and colleagues, concluding that cancer drug prices rose by 10% annually—an average of $8,500 per year—from 1995 to 2013. That study was published earlier this year in the Journal of Economic Perspective.

Among actions being urged by the oncologists is creation of a post-FDA drug approval review mechanism that would propose a “fair” price for new treatments based on their value to patients and heathcare.

The call for basing drug prices on value comes several weeks after two key oncology groups unveiled separate measures designed to assign value to cancer treatments. Last month the American Society of Clinical Oncology (ASCO) issued its initial conceptual Value Framework, while the European Society for Medical Oncology (ESMO) in May unveiled the ESMO Magnitude of Clinical Benefit Scale (ESMO-MCBS). Separately, doctors at Memorial Sloan Kettering Cancer Center have developed DrugAbacus, an interactive tool for calculating the value of cancer drugs.

In their commentary, the 118 oncologists said ASCO and other U.S. groups should be encouraged to consider “the overall value of drugs and treatments” in formulating treatment guidelines. Those groups include the American Society of Hematology, American Association for Cancer Research, American Cancer Society, and National Comprehensive Cancer Network.

The oncologists also called for:

• Negotiation of drug prices between Medicare and drug developers
• Evaluation of new treatment benefits by the Patient Centered Outcomes Research Institute (PCORI), the private, nonprofit created by the Affordable Care Act. The cancer doctors also urged similar organizations to include drug prices in assessing treatment value
• Importation of cancer drugs across borders for personal use. The doctors said Canadian drug prices are about half of those in the U.S.
• Legislation barring drug companies from delaying access to generic drugs, a practice called “pay for delay”
• Reform of the U.S. patent system to discourage “evergreening” or prolonging of product exclusivity

The actions sought by the oncologists echo those proposed in a change.org petition addressed to President Obama, Health and Human Services Secretary Sylvia Mathews Burwell, and all members of Congress. The petition by “concerned citizens” had been signed by 6,029 supporters as of 9 a.m. ET today.

“With proper support of these grass-roots efforts and proper use of that support downstream, it should be possible to focus the attention of pharmaceutical companies on this problem and to encourage our elected representatives to more effectively advocate for the interests of their most important constituents among the stakeholders in cancer—American cancer patients,” the group of oncologists stated.

One of the 118 oncologists— Hagop Kantarjian, M.D., of University of Texas MD Anderson Cancer Center—was the corresponding author of a 2013 article decrying rising cancer drug prices that was co-authored by some 120 investigators and other experts in chronic myeloid leukemia. The article was published in the American Society of Hematology journal Blood.