CANCER DRUGS COST TOO MUCH, Ch III (Or maybe IV)

Hard at work

 

This blog comes to you from Dick Ingwall via the NY Times.  It contains nothing particularly new, but does summarize well some of the topics we have discussed many times before.  Specifically, it returns once again to the questions “Why do drugs cost so much, and what can we do about it?”

The underlying kernel of reportage here concerns an article published by the Mayo Clinic and signed by 100 of the nation’s top oncodocs (U.W. and Fred Hutch are prominently represented).  Here is the article:

http://www.mayoclinicproceedings.org/article/S0025-6196(15)00430-9/fulltext

And here is the gist:

1)      Cancer will effect one in three adults during their lifetime.  (Does that include skin cancer?)

2)      Recent trends have resulted in 20 to 30% of out-of-pocket expense by cancer patients.  This is after insurance payments.

3)      In 2014 all new cancer drugs approved by the FDA cost over $120,000 per treatment.

4)      Given that the average household gross income in the U.S. is $52,000/year, paying for this 20-30% of $120,000 drugs will leave the patient and his/her family hard up for food and housing.

5)      Because cancer is predominantly a disease of old people, and in view of the fact that old people are accumulating like ants at a picnic, this economic problem is bound to get worse, fast.

And what to do about it?

1)      Create a governmental panel to propose prices, based on need and cost

2)      Allow Medicare to negotiate drug prices directly with Big  Pharma.

3)      Allow another governmental agency, one already created under ObamaCare, to evaluate the drug’s efficacy, and adjust prices accordingly.

4)      Permit importation of drugs from abroad.

5)      Prevent Big Pharma from delaying the introduction of generic drug-equivalents.

6)      Screw around with patenting procedures, ostensibly to make it harder for Big P to get exclusivity in the first place.

7)      Get the right, in-the-know organizations to revise treatment guidelines.

As you know, I am suspicious of governmental panels so much of this leaves me skeptical.  However, there being no practical way to invoke market forces in this industry, something similar to this may be inevitable.

I found this Mayo clinic article by reading a related story in the NY Times.  The Times relates that the Obama Administration (through the agency of Medicare) has reversed itself and approved payment for a cancer drug called Blincyto (actual name blinatumomab; developed by Amgen – don’t you wish you had bought its stock?).  Blincyto combats acute lymphoblastic leukemia, described as being particularly “aggressive”.  A “course” of Blincyto – two 28-day sessions – costs $178,000, not counting hospital expenses.  If you are making $50,000/year and end up paying 20% of the cost, you are out $35,600, or 71.2% of your yearly gross income.  Let’s hope the damned stuff works.

Here is the article:

http://www.nytimes.com/2015/08/09/us/medicare-reversing-itself-will-pay-more-for-an-expensive-new-cancer-drug.html?smprod=nytcore-ipad&smid=nytcore-ipad-share

The moral seems to be – let’s figure out how to stop people from getting acute lymphoblastic leukemia.