Oncologists not prescribing expensive cancer drugs


In the latest controversy over the high cost of certain prescription medications, a recent Reuters article said that more oncologists won’t prescribe expensive drugs.

In the latest controversy over the high cost of certain prescription medications, a recent Reutersarticle said that more oncologists won’t prescribe expensive drugs.

In the article, doctors and health insurers criticized the cost of the colon cancer drugs Cyramza from Eli Lilly & Co., Genentech’s Avastin and Stivarga from Bayer AG, as well as Celgene's Abraxane for breast cancer.

Related:Hospital pharmacists protest higher cancer drug costs in survey

Global spending on cancer medicines reached $100 billion in 2014, an increase of 10%, according to the article. Plus, of 51 cancer drugs approved between 2009 and 2013, 21 treatments classified as "novel" had a median annual price of $116,100, while the 30 deemed "next-in-class" had a median price of $119,765.

"There are drugs that don't make much sense given how much they cost, given their small benefits," Peter Bach, MD, director of Memorial Sloan Kettering's Center for Health Policy and Outcomes in New York, told Reuters. "There are drugs that can cost up to $10,000 a month that provide, at the median, a few weeks or less than a month of additional life, but with substantial toxicity."

In addition, Anthem said Avastin and Abraxane are overused, relative to their value. "Abraxane is a newer version of an older (generic) drug called paclitaxel-they basically do the same thing," Jennifer Malin, MD, medical director for oncology at Anthem and an attending physician at the Veterans Affairs Greater Los Angeles Health Care System, told Reuters. However, Paclitaxel costs around $200 per dose compared with $10,000 for Abraxane, Malin said.


NEXT: Clinical studies on cancer drugs


However, clinical studies on some of the criticized cancer medications tell a different story. For example, The German Breast Group (GBG) said nab-paclitaxel (ABRAXANE) demonstrated significant benefit for patients with early high risk breast cancer when compared to conventional solvent-based paclitaxel. The study found a 9% absolute improvement from 29% to 38% in the pCR (pathological complete response) rate, when neoadjuvant (preoperative) chemotherapy was started with nab-paclitaxel instead of conventional solvent-based paclitaxel followed by epirubicin/ cyclophosphamide given all before surgery.

Related: Americans want drug pricing reform

And findings from the IMPACT study on Abraxane for pancreatic cancer showed a 59% increase in 1-year median survival rates from less than a quarter of the patients (22%) to more than a third (35%) compared to the standard of care.

In addition, the Reuters article did not present both sides of the pricing debate, Jonathan Wilcox, cofounder of Patients Rising, told FormularyWatch. "Scientists maintain that Abraxane is a far advanced therapy, delivering benefits that not only save lives but also can deliver the enormous economic benefits of life and health,” Wilcox said. “Wouldn't it make sense to at least hear them out? Citing doctors from insurance companies and known pharma critics….reinforces the one-sided character of Beasley's reporting.”

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