The early winners and losers in ASCO's highly anticipated cancer drug scorecard
- The American Society of Clinical Oncology (ASCO) has published a long-promised drug scorecard in the Journal of Clinical Oncology.
- ASCO's drug scorecard is designed to simplify therapeutic decision-making by comparing survival data for different regimens with costs and side effects.
- Therapeutic regimens are rated on a scale of 0 to 100, and in some cases 0 to 130. In many cases the same regimen is given a different score for different indications.
Last summer, BioPharma Dive wrote about the cancer drug scorecard, which was in development, as a potentially promising decision-making tool for oncologists to use with their patients. Although the scorecard is still being vetted by the medical community and by ASCO, the basic framework is in place and has raised some eyebrows as it ruthlessly quantifies the value of some therapeutic regimens versus others, some with very low scores.
Overall, the scorecard takes into effect clinical benefits, side effects, quality of life, overall survival, progression free survival, costs, and other factors. Using an algorithm based on these metrics the scorecard gives a $9,200 (per month) Alimta-based cocktail for lung cancer a score of zero. (Note: Alimta is an Eli Lilly drug.) In another case, a Jevtana-based combo for treatment of prostate cancer, which costs $10,700, scores 16 points. (Note: Jevtana is a Sanofi drug).
On the higher end of the scale, Johnson & Johnson's Zytiga was rated 42 (out of 130) when combined with prednisone for treatment of prostate cancer. The regimen costs $7,500 per month. And on the high-scoring end, treatment regimens that include Roche's Herceptin (along with doxorubicin, cyclophophamide and paclitaxel) for the treament of HER-2 positive breast cancer at 48.
Overall, the scorecard aims to help oncologists and patients understand value as it relates to stark survival and cost factors. While it may be alarming in some cases, it will eventually become a useful, go-to tool for the oncology community, as well as for patients and most likely payers.