- Research over a six-month span last year shows U.S. hospitals marked up the price of cancer drugs for patients with private health insurance, in some cases charging people more than seven times what the facilities paid to buy the medicines, according to a study published Monday in JAMA Internal Medicine.
- Prices varied considerably across insurers and facilities in the study, with the median drug price markup across all cancer centers and payers ranging between 118% and 634%.
- Researchers also found that most National Cancer Institute-designated facilities did not publicly disclose payer-specific prices for cancer drugs, as federal price transparency regulators require.
Last year a government rule requiring hospitals to disclose the prices they negotiate for services went into effect. But the mandate hasn't stopped hospitals from charging widely varying fees for procedures, sometimes even within the same facility.
That's true for cancer drugs too, as JAMA researchers found most cancer centers aren't complying with the price disclosure rule, and the prices they charge differ drastically across centers and for patients with different private insurance coverage.
Researchers examined private payer-specific negotiated prices for 25 commonly used injectable or infusible cancer medicines at 61 NCI-designated facilities. They used publicly available hospital price transparency files, conducting the study from April 1 to Oct. 15 of 2021.
Among the 61 NCI-designated cancer centers analyzed, just 44% disclosed the price paid for at least one top-selling cancer therapy.
Across different hospitals, price ratios for cancer therapies ranged between 2.2 for the Roche breast cancer drug Perjeta and 15.8 for the chemotherapy leuprolide.
At the same center, price ratios for cancer therapies ranged between payers from 1.8 for the SeaGen blood cance treatment Adcetris to 2.5 for Roche's Avastin.
At one center, negotiated prices for 7.5 mg of leuprolide ranged between $692 and $3,284 per milligram, researchers found.
Public policies to discourage or prevent excessive hospital price markups on cancer therapies could benefit patients as rising costs are a major concern, researchers wrote.
U.S. spending on cancer drugs increased from $39.1 billion in 2015 to $67.5 billion in 2019, in large part due to manufacturer and hospital market power, according to the study.
Manufacturers benefit from time-limited monopolies during periods of patent and regulatory exclusivity, and hospitals then institute high prices for cancer therapies from private insurers, researchers wrote.