Are we ready to assess the value of cancer drugs?

Cancer drugs have been well known for their high price tag. Cost of newly approved cancer drugs routinely exceeds $10,000 per patient per month. A single new immunotherapy to treat melanoma could cost $1 million per patient per year if used at the higher dose, according to a recent presentation by Leonard Saltz, MD, at the 2015 American Society of Clinical Oncology (ASCO) Annual Meeting.

To drive up the cost of treatment even further, Saltz, also presented the findings of a new study that have shown positive results by combining two different immunotherapies to treat melanoma at a cost of nearly $30,000 per patient per month.

The cost of new cancer drugs is more relevant than ever, as there is an increasing demand for cancer care. Nearly one in three Americans will develop cancer in their lifetime; the National Cancer Institute projects a 30% increase in number of cancer survivors and 26% increase of national expenditure on cancer care, approaching $150 billion by 2020.

The cost of cancer drugs, although not a significant percentage of the total expenditure of cancer care, it is rising to the point that ultimately it will impact patients directly if there is a cost share component of the out-of-pockets. Few studies found that patients experiencing financial distress and hardship are less likely to adhere to the prescribed therapy despite its benefit, according to studies published in the New England Journal of Medicine and Journal of Clinical Oncology.

In addition, a study found that cancer patients are more likely to experience bankruptcy than individuals without cancer, according to a study published in Health Affairs. This is the dilemma cancer patients are challenged with, collectively is what is called, the “financial toxicity” of cancer treatment which is a major concern for patients and their oncologists, according to a study published in Oncology.

Several value assessment tools emerged in response to the escalating drug prices. The focus is not just about the cost, but it’s about the value and quality of cancer care we can afford to deliver to our patients. Defining value in healthcare is complicated and elusive; it depends on the perspectives of the stakeholders. The definition on value of prescription drugs also varied from different organizations (e.g., Institute for Clinical and Economic Review (ICER), ASCO.

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