Print“If a $7,000 drug is substantially better in some way, it would get a higher value score,” Schnipper said. “But if a lower cost treatment is very close or equivalent, then, the answer to that is self-evident.”
As the American Society of Clinical Oncologists, or ASCO, prepares to rate cancer drugs not only on effectiveness and safety but also on cost of treatment, two researchers from the National Cancer Institute published a perspective piece in the New England Journal of Medicine noting that the price of some cancer drugs are so high that they prevent “comparative effectiveness trials that would seek to establish equally effective but cheaper alternatives.”
As an example, they say it would cost almost $70 million to run a trial comparing Johnson & Johnson’s prostate cancer drug Zytiga with ketoconazole, a generic prostate cancer drug. Ketoconazole is a logical comparator to Zytiga because both have a similar mechanism of action. It costs about $500 to $700 a month to treat a patient with prostate cancer with the generic, compared to $7,000 a month to use Zytiga.
If just half of the patients who die of prostate cancer in the United States each year were treated with the cheaper drug, say the researchers, the government and private insurers would save more than $1 billion each year.
“It would be unwise, however, for Johnson & Johnson to fund such a study, since its findings could only erode the company's market share,” write Sham Mailankody and Vinay Prasad of the Medical Oncology Service at the National Cancer Institute.
The researchers say it is also unlikely for J&J to enable a comparator trial by providing their drug for free.
The researchers also estimated the cost to run comparative trials of four other branded cancer drugs, including Bristol-Myers Squibb’s Taxol for metastatic pancreatic cancer and Bayer Healthcare’s Stivarga for metastatic colorectal cancer.
Meanwhile, ASCO has convened a Value in Cancer Care Task Force to come up with an algorithm that will evaluate a drug’s clinical effectiveness and side effects and integrate them with its cost. It could then assign a value that would describe the “optimal clinical outcome for our patients over the financial impact on the patient and society,” task force chair Lowell Schnipper told Modern Healthcare.
“If a $7,000 drug is substantially better in some way, it would get a higher value score,” Schnipper said. “But if a lower cost treatment is very close or equivalent, then, the answer to that is self-evident.”
The task force hopes to develop an algorithm by the fall. The ASCO annual meeting at the end of May will include special workshops focused on cost and value.
April 21, 2014
http://www.burrillreport.com/article-comparative_effectiveness_studies_of_cancer_drugs_is_costly.html
