During the past decade, the price of cancer drugs and the spending for cancer treatments by Medicare have increased dramatically. The author outlines the usual tools Medicare uses to control its ...spending on drugs and discusses the policies that make cancer drugs a special case and prohibit the regulation of their prices and utilization.
The price of cancer drugs and the spending for cancer treatments by Medicare have increased dramatically. Dr. Peter Bach outlines the usual tools Medicare uses to control its spending on drugs and discusses the policies that make cancer drugs a special case and prohibit the regulation of their prices and utilization.
Fifteen years ago, the only commonly used cancer drug on the market that cost more than $2,500 per month was paclitaxel (Taxol, Bristol-Myers Squibb), which Chabner and Roberts labeled the first cancer “blockbuster.”
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Today, cancer drugs that come on the market routinely cost many times that amount (Figure 1). Several established cancer drugs have recently seen price increases, which has added to the general upward trend in prices. Nitrogen mustard, a drug that has been used to treat cancer since 1949, saw its price for a course of treatment increase by a factor of 13 between the beginning and the . . .
A major concern of policy makers is that the price of drugs like cancer drugs is not currently linked to its benefits. Linking pricing to the indication is a means of addressing the substantial ...different in the value as measured by cost per year of life gained.
Feng et al studied whether late-stage cancer, rather than cancer-specific mortality, was an acceptable alternative end point in clinical trials of cancer screening. The authors analyzed 41 clinical ...trials conducted in Europe, North America, and Asia, combining the data overall and according to cancer type. They evaluated the association between incidence of stage III-IV cancer and cancer-specific mortality in and across the selected studies. To understand the importance of the study by Feng et al, consider the accepted rationale for cancer screening. Cancer is commonly fatal, and outcomes are better for patients diagnosed with early-stage cancer than for those diagnosed with late-stage cancer. Therefore, detecting cancer at an early stage, rather than a late stage, should presumably save lives.
With more expensive drugs being introduced, some of them for highly prevalent conditions, and the pace of generic conversion slowing, policymakers may want to consider cost-effectiveness analyses for ...coverage decisions — but there would still be a budgetary problem.
Nowadays, the reality of exorbitant drug pricing overshadows even the most exceptional stories of drug efficacy. It's true that we're making huge biomedical strides, yet it's also true that prices for new drugs are rising, as are prices of existing treatments.
A case in point is nivolumab, which, as Motzer et al. report in this issue of the
Journal
(pages 1803–1813), appears to extend median survival in patients with metastatic renal-cell cancer by nearly half a year. But the cost to insurers and patients of using the drug for this condition — by my estimate, around $65,000 for Medicare beneficiaries . . .
The article discusses the key aspects that the U.S. Food and Drug Administration (FDA) keeps in mind when it comes to value-based pricing for drugs. Some of the different themes that are applied as ...well as variations undertaken are highlighted.
Even if CMS concludes that CAR-T therapy provides a net benefit for Medicare patients, it could limit who can provide the therapy, require collection of further outcome data, limit coverage to ...clinical trials, and design a payment approach promoting price competition.
Pricing in the Market for Anticancer Drugs Howard, David H.; Bach, Peter B.; Berndt, Ernst R. ...
The Journal of economic perspectives,
2015, Letnik:
29, Številka:
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Journal Article
Recenzirano
Odprti dostop
In 2011, Bristol-Myers Squibb set the price of its newly approved melanoma drug ipilimumab—brand name Yervoy—at $120,000 for a course of therapy. The drug was associated with an incremental increase ...in life expectancy of four months. Drugs like ipilimumab have fueled the perception that the launch prices of new anticancer drugs and other drugs in the so-called “specialty” pharmaceutical market have been increasing over time and that increases are unrelated to the magnitude of the expected health benefits. In this paper, we discuss the unique features of the market for anticancer drugs and assess trends in the launch prices for 58 anticancer drugs approved between 1995 and 2013 in the United States. We restrict attention to anticancer drugs because the use of median survival time as a primary outcome measure provides a common, objective scale for quantifying the incremental benefit of new products. We find that the average launch price of anticancer drugs, adjusted for inflation and health benefits, increased by 10 percent annually—or an average of $8,500 per year—from 1995 to 2013. We argue that the institutional features of the market for anticancer drugs enable manufacturers to set the prices of new products at or slightly above the prices of existing therapies, giving rise to an upward trend in launch prices. Government-mandated price discounts for certain classes of buyers may have also contributed to launch price increases as firms sought to offset the growth in the discount segment by setting higher prices for the remainder of the market.
Approval of the drug tisagenledeucel (Kymriah; Novartis) by the US Food and Drug Administration (FDA) for the treatment of pediatric and young adult acute lymphoblastic leukemia, definitively ...shattered oncology drug pricing norms for its list of price $475 000. The price of this therapy should serve as a reminder that future revenue outlooks for a pharmaceutical company are in part related to the ability to generate many millions in revenue even when few patients benefit from the new therapies. The price of $475 000 for a single treatment with tisagenledeucel is difficult to put into context because expensive cancer treatments typically cost $10 000 to $20 000 per month and reflect prices that have already increased more rapidly than the benefits they have provided patients over the past several decades.
Federal government and payers identify opportunities to adopt structural changes that benefits pharmaceutical manufacturers who price products based on value they bring to patients. Pharmaceutical ...products long term sustainability depends on a system wherein pricing gets linked to value of products, with payers and regulators providing right incentives to companies to adopt those prices.
Lung cancer is by far the major cause of cancer deaths largely because in the majority of patients it is at an advanced stage at the time it is discovered, when curative treatment is no longer ...feasible. This article examines the data regarding the ability of screening to decrease the number of lung cancer deaths.
A systematic review was conducted of controlled studies that address the effectiveness of methods of screening for lung cancer.
Several large randomized controlled trials (RCTs), including a recent one, have demonstrated that screening for lung cancer using a chest radiograph does not reduce the number of deaths from lung cancer. One large RCT involving low-dose CT (LDCT) screening demonstrated a significant reduction in lung cancer deaths, with few harms to individuals at elevated risk when done in the context of a structured program of selection, screening, evaluation, and management of the relatively high number of benign abnormalities. Whether other RCTs involving LDCT screening are consistent is unclear because data are limited or not yet mature.
Screening is a complex interplay of selection (a population with sufficient risk and few serious comorbidities), the value of the screening test, the interval between screening tests, the availability of effective treatment, the risk of complications or harms as a result of screening, and the degree with which the screened individuals comply with screening and treatment recommendations. Screening with LDCT of appropriate individuals in the context of a structured process is associated with a significant reduction in the number of lung cancer deaths in the screened population. Given the complex interplay of factors inherent in screening, many questions remain on how to effectively implement screening on a broader scale.
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