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Physicians Propose Solutions for High Cost of Cancer Drugs

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Multiple factors lead to high cost of cancer therapy

Cancer treatment protocols is one reason a virtual monopoly is held by some cancer drug manufacturers, which in turn helps to create the high cost of cancer drugs in the United States, according to a commentary by 2 Mayo Clinic physicians in a recent issue of the journal Mayo Clinic Proceedings.

“Cancer care is not representative of a free-market system, and the traditional checks and balances that make the free-market system work so efficiently in all other areas are absent when it comes to most cancer treatment,” write authors, Mustaqeem Siddiqui, MD, an oncologist, and Vincent Rajkumar, MD, a hematologist.

For instance, a physician or patient can choose between multiple antibiotic drugs to treat a given infection. In contrast, cancer drugs are administered to patients sequentially or in combination, creating a virtual monopoly for each drug. Siddiqui and Rajkumar state that this is one of the principal reasons for the high cost of cancer medications.

According to the authors, other factors creating high costs include: the expense of drug development; the high price that patients and insurers are willing to pay for even modest improvement in outcomes; and a lack of regulations to account for economic and value-based considerations in the drug approval and pricing process.

Siddiqui and Rajkumar offer these solutions:

  • Value-based pricing that includes discrete metrics such as an incremental cost effectiveness ratio per quality-adjusted-life-years gained, as a result of a particular treatment. Quality-adjusted-life-years is an estimate of the number of years added to a patient’s life by a specific drug intervention, adjusted for quality of life.
  • An FDA mandate requiring drug companies to submit a value profile when seeking drug approval, giving patients and physicians the ability to make better-informed decisions about treatment.
  • Centers for Medicare and Medicaid Services powers to negotiate payments for cancer drugs.
  • Improved national cancer guidelines providing evidence-based analysis of quality of life, mortality data, benefits, risks, and cost for all possible treatment options.
  • Monopoly rules to determine if a particular drug will operate in a monopoly situation. Such drugs would be subject to legally mandated or voluntary price controls in exchange for expedited approval or other remedy.
  • Nonprofit generic drug companies to manufacture and distribute generic cancer drugs at a very low cost.

Source: Mayo Clinic