- A federal panel urged the Trump administration to make the increasing cost of cancer drugs a national priority, highlighting the rising number of new treatments with price tags above $100,000 per year. At the same time, the panel did not advocate for any direct or unilateral action to bring down drug prices.
- The President's Cancer Panel recommended a range of potential policy priorities, such as promoting value-based payments in oncology and increasing cost transparency. It did not target any specific sector within the overall healthcare industry.
- "Urgent action is needed to address ongoing, rapid increases in cancer drug costs while continuing to stimulate innovation in drug development," wrote the three authors on the panel. "This complex problem will not be solved quickly or easily, and it will not be solved by any organization or sector working alone."
Over the past half-decade, several new classes of oncology therapies have entered the market, improving on the standard of care in melanoma, lung cancer and hematological malignancies (among others).
Immunotherapies have taken a place alongside targeted treatment and chemotherapy in physician's toolboxes, while cell therapies hold out the promise of lasting remission in a subset of patients with certain blood cancers.
All of those advancements in clinical science, though, come with steep prices. As the panel's report notes, cancer drugs regularly carry price tags over $100,000 per patient per year.
Recently approved CAR-T therapies from Novartis AG and Gilead Sciences Inc. set an even higher bar, costing respectively $475,000 and $373,000 per one-time treatment.
"Some cancer drugs have been transformative—significantly improving patients’ outcomes and, in some cases, producing long-term remissions," wrote the panelists in their report. "However, many new drugs do not provide benefits commensurate with their prices."
A particular concern of the panel is a concept known as "financial toxicity," which describes how high cost of care can affect patient quality of life. Patients prescribed drugs with high out-of-pocket costs, for example, may choose to skip doses or otherwise limit use to avoid paying the full annual price.
"We heard patients say that their peers worry about having to choose between paying for their medicines or their mortgages. That is a choice no one in this country should have to make."
The panel, which consists of three members appointed by President Barack Obama in 2011 and 2012, did not advance any concrete proposals for new regulations or legislative changes. Instead, recommendations stuck to broader structural ideas, such as increasing use of value-based pricing in cancer.
Value-based or outcomes-based pricing is not a novel concept, but most publiclyannounced deals have involved drugs for diabetes, high cholesterol or hepatitis C. An arrangement between AstraZeneca plc and the pharmacy benefit manager Express Scripts Holding Co. over the British pharma's cancer drug Iressa (gefitinib) is one of the only examples in oncology.
The panel noted more work needs to be done to develop frameworks to assess the value and cost-effectiveness of medicines, pointing toward efforts in that direction made by the Institute for Clinical and Economic Review.
More broadly, the panelists recommended policy action to change prescribing incentives toward promotion of the highest-value drugs and away from the highest-cost.
Overall, the report appeared to tread carefully between criticizing rising prices and acknowledging the need for biopharma companies to earn a sufficient return to encourage continued investment.
Indeed, insurer willingness to cover high-cost cancer drugs is one factor driving the industry to invest more heavily in oncology drug development.
Other proposed policy recommendations focused on promoting greater transparency, and encouraging more conversations between patients and providers about drug costs.