Uncovering the Complexity of US Cancer Drug Pricing

In a study published in Value in Health, researchers delve into the complex world of cancer drug pricing in the US, shedding light on the factors influencing these costs. The study's objectives center around the rising prices of cancer drugs, particularly focusing on original and supplemental indications. While drug prices have been a contentious issue for years, the pricing of supplemental indications—additional uses for already-approved drugs—remains relatively unexamined.

The research analyzed data from 2003 to 2022, including clinical trial evidence, epidemiologic data, efficacy data, and FDA approvals from the Drugs@FDA database, ClinicalTrials.gov, and the Global Burden of Disease study. The study encompassed 145 drugs across 373 cancer indications, with an average monthly treatment cost for Medicare patients reaching approximately $24,444.

One notable finding revealed that for original indications, drug prices showed a weak correlation with improvements in overall survival and progression-free survival. Instead, the prices were associated with various factors, including disease incidence, first-in-class status, gene and cell therapies, hematologic cancers, and severe diseases with significant unmet needs. The study also uncovered that prices for supplemental indications were not closely tied to their efficacy, clinical evidence, or epidemiology.

Researchers argue that high drug prices can lead to financial toxicity, hinder treatment adherence, and exacerbate healthcare disparities. While the pharmaceutical industry claims that high prices are necessary to fund research and development, the study suggests that the link between high prices and innovative medicines is not always clear.

With the growing interest to address drug pricing issues in the US, and with recent legislative changes granting the government the authority to negotiate drug prices directly with manufacturers, there is a shift towards transparency, and regulation in drug pricing could have significant implications for the pharmaceutical industry and patients alike.

Study findings emphasize the need for more nuanced pricing policies that reflect the value of each indication. It highlights the importance of considering factors beyond just clinical efficacy when determining drug prices and suggests that a more comprehensive approach to drug pricing is warranted to ensure affordability and access for patients.

"Drug prices are not aligned with the survival benefit they offer to patients but the unmet medical needs they fill and the biotechnological innovation they achieve," said researchers.

Reference

Michaeli DT, Michaeli T. Cancer drug prices in the United States: efficacy, innovation, clinical trial evidence, and epidemiology. Value in Health. Published online July 28, 2023. doi:10.1016/j.jval.2023.06.020