Cancer drugs’ high cost out of reach for many patients, doctors say

April 25, 2013

Cancer medicines that cost more than $100,000 a year aren’t morally justifiable and may keep patients from getting the life-saving treatment, a group of more than 100 leukemia doctors said.

Of the 12 cancer medications the Food and Drug Administration approved last year, 11 cost more than $100,000 annually, the physicians said in an article in Blood, the journal of the American Society of Hematology, published online Thursday.

The paper highlights the debate over how much leeway drugmakers should have in setting the prices of cancer medicines and whether pricing practices harm patients and health-care systems. Although companies should be allowed to profit, a product that can help a patient survive should be priced affordably, the cancer specialists said.

“Hopes that the fundamentals of a free market economy and market competition will settle cancer drug prices at lower levels have not been fulfilled,” the doctors said in the paper.

Drugmakers said they charge lower prices than those quoted in the article and pointed to programs that help patients afford their medication.

Pfizer, whose leukemia medicine Bosulif was approved in December and costs about $98,000, helps financially eligible patients get their prescriptions free or at a discount, and insured patients pay no more than $50 a month, said Victoria Davis, a spokeswoman for New York-based Pfizer, the world’s biggest drugmaker. The article said Bosulif costs $118,000 annually.

“We wholeheartedly agree that patients should have access to the medications they need, and Pfizer has developed various programs to support CML patients gaining access to Bosulif,” Davis said.

The paper was written by doctors who specialize in chronic myeloid leukemia, which accounts for about 10 percent of the 48,610 new leukemia cases estimated by the National Cancer Institute. The survival rate hovers around 60 percent for the disease in the United States, compared with 80 percent in Sweden. Costs in Sweden are managed and patients may be more likely to comply with treatment while they don’t have the same cost concerns as U.S. patients, the doctors said.

“We believe that lowering the prices of CML drugs might improve accessibility to treatment and increase treatment adherence,” Hagop Kantarjian, chairman of the Leukemia Department at the University of Texas MD Anderson Cancer Center and an author of the article, said in a statement. Reducing the prices would increase the number of patients who live longer because they would be able to continue on the medications, known as tyrosine kinase inhibitors, he said.

Tyrosine kinase inhibitors, which include Novartis AG’s Gleevec and Ariad Pharmaceuticals’ Iclusig, have helped reduce mortality to 2 percent vs. 10 percent to 20 percent in the early 2000s, the doctors said.

About 5,920 new cases of chronic myeloid leukemia and 610 deaths from the disease are expected in the United States this year, according to the American Cancer Society. Chronic myeloid leukemia is one of the four main types of leukemia in adults. It is a slowly progressing blood and bone-marrow disease that rarely occurs in children, according to the National Cancer Institute.

Gleevec, the standard treatment for chronic myeloid leukemia, cost $30,000 a year when it was approved in 2001 and its price has tripled, the doctors wrote.

The majority of U.S. patients pay less than $100 out of pocket per month for Gleevec, according to a statement from Novartis, based in Basel, Switzerland. The company also has given Gleevec or its other drug for chronic myeloid leukemia, Tasigna, free to an average of 5,000 uninsured or underinsured patients every year for the past five years, Novartis said.

— Bloomberg News

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