Cancer Drug costs as reported in USA Today

In the Tuesday July 11, 2006 there were several articles about the ridiculous costs of cancer drugs and treatments. Here are a couple of the articles:

http://blogs.usatoday.com/ondeadline/2006/07/cancer_drug_pri.html

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LONGER LIFE, HIGHER COST

Effect of drugs on patients who have advanced colorectal cancer:


For drugs available in 1996
Total cost: $500
Expected survival: 11 months


For drugs available today
Total cost: $250,000
Expected survival: 24 months


Source: Leonard Saltz, Memorial Sloan-Kettering Cancer Center




VARIOUS TREATMENTS, COSTS

Some doctors and patients are concerned about the price of new cancer therapies.

Drug Company Monthly cost

Avastin Genentech $4,400

Erbitux ImClone/Bristol-Myers $10,000

Gleevec Novartis $2,600

Herceptin Genentech $3,000

Nexavar Bayer Pharmaceuticals $4,300

Revlimid Celgene $4,500

Rituxan Genentech $4,200 to $13,000 1

Sutent Pfizer $4,000

Tarceva Genentech/OSI Pharmaceuticals $2,400 to $2,700 1


1 Cost varies with type of cancer treated.

Sources: manufacturers




Prices soar for cancer drugs
Updated 7/11/2006 9:04 AM ET E-mail | Save | Print | Reprints & Permissions | Subscribe to stories like this

By Liz Szabo, USA TODAY
Spiraling prices for new cancer therapies — up to $10,000 a month for a single drug — are causing alarm among patients and insurance companies.
"These costs are out of control," says Fran Visco, president of the National Breast Cancer Coalition, which is planning a conference focused on drug costs in the fall. "We can't allow it to continue."

DEBATE: The price of patients' hope | Your thoughts?

The cost of a cancer drug prescription rose nearly 16% last year, compared with 3% for other prescriptions, says a June report by Express Scripts, a pharmacy benefit manager. The average cost of a 30-day prescription for cancer drugs is now nearly $1,600. The report does not include drugs given at a doctor's office, such as Avastin.

Barbara Brenner of Breast Cancer Action says she is especially troubled by the cost of Avastin, a newer drug used to treat colorectal cancer that now sells for about $50,000 a year. That price could jump to $100,000 if Avastin is approved to treat breast and lung cancers, because those tumors are treated with higher doses of the medication.

"It's really exploiting the desperation of people with a life-threatening illness," says Marcia Angell, former editor of The New England Journal of Medicine.

In the past decade, researchers have been enthusiastic about Avastin and other "targeted" therapies, which are designed to attack tumors while causing fewer side effects than conventional drugs. These therapies may give patients a few more months, but they are not a cure. Given those limitations, Angell and others question whether the drugs are worth the price.

Tarsha Echols, 34, a flight attendant in Memphis, began taking Herceptin last year to keep her Breast Cancer from returning. That was before her employer cut her salary 35%. She plans to stop taking the drug Monday — a year early — because her health plan now requires her to pay 20% of her medical costs, or about $800 a month. That's more than her rent. "I hope that whatever I've gotten so far is enough," she says.

Rising cancer costs affect all Americans, says Sharon Levine of The Permanente Medical Group of Kaiser Permanente, the country's largest non-profit health maintenance organization. Taxpayers absorb much of the bill because most cancer patients are covered by government insurance such as Medicare.

Drug industry leaders say they try to make sure patients get the drugs they need. Companies gave away more than $8 billion in cash and products to poor or uninsured patients last year, according to the Pharmaceutical Research and Manufacturers of America.

Walter Moore, Genentech's vice president of government affairs, says profits help pay for research. "One can't be in business without returning a profit," he says. "To get the returns to be able to spend the money to do the things we want to do, we have to price the way we price."

Posted 7/10/2006 11:18 PM ET
Updated 7/11/2006 9:04 AM ET E-mail | Save | Print | Reprints & Permissions | Subscribe to stories like this


Enlarge Genentech handout

Avastin, a newer drug used to treat colorectal cancer, sells for about $50,000 a year. That price could jump to $100,000 if Avastin is approved to treat breast and lung cancers, which require higher doses.

______________________________________________________________________

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VARIOUS TREATMENTS, COSTS

Some doctors and patients are concerned about the price of new cancer therapies.

Drug Company Monthly cost

Avastin Genentech $4,400

Erbitux ImClone/Bristol-Myers $10,000

Gleevec Novartis $2,600

Herceptin Genentech $3,000

Nexavar Bayer Pharmaceuticals $4,300

Revlimid Celgene $4,500

Rituxan Genentech $4,200 to $13,000 1

Sutent Pfizer $4,000

Tarceva Genentech/OSI Pharmaceuticals $2,400 to $2,700 1


1 Cost varies with type of cancer treated.

Sources: manufacturers




Cost of cancer drugs crushes all but hope
Updated 7/11/2006 10:50 AM ET E-mail | Save | Print | Reprints & Permissions | Subscribe to stories like this

By Liz Szabo, USA TODAY
When Tom Reek was diagnosed with a rare leukemia at age 65, doctors said he might live only another three years. Today, Reek is thriving at age 72, thanks to a drug called Gleevec.
"I used to kid around and say that I feel like Clark Kent," says Reek, who lives on Long Island, N.Y., and volunteers as a peer counselor with other patients, including youngsters. "It's like a gift from God to be able to work with these children."

The only downside to Gleevec, Reek says, is the cost: $3,100 a month. Reek went back to work four years ago as a truck driver, delivering blood tests and lab results to medical offices. With insurance, his pills cost only about $50 a month.

Since Gleevec was approved in 2001, researchers have hoped that every new cancer therapy would copy its success: a convenient pill that lets patients live for years with relatively few serious side effects. Though experts say few of the new "targeted" therapies come close to that ideal, they do have one thing in common with Gleevec: They're all incredibly expensive.

PRESCRIPTION COSTS: Prices soar for cancer drugs

Some doctors are questioning whether targeted therapies — designed to turn cancer into a chronic disease by silencing growth signals inside malignant cells — are worth the expense to individuals and taxpayers.

Most new cancer drugs improve survival by only a few weeks or months, says researcher Leonard Saltz of New York's Memorial Sloan-Kettering Cancer Center. Although Erbitux, for example, costs almost $10,000 a month, studies have not shown that it helps colorectal cancer patients live longer.

"There is a real question whether insurance ought to pay for a drug like that," says Ezekial Emanuel, chairman of clinical bioethics at the National Institutes of Health clinical center. "If you pay for something that doesn't have a big impact, you could lose out on treatments that really do work.

"We can cure testicular cancer. We can cure Hodgkin's disease. You don't want to skimp on that."

Canada has decided that Erbitux isn't worth the money. Last month, Bristol-Myers Squibb Canada announced that it won't sell Erbitux there because it couldn't get "an appropriate price for its product reflecting the value of the innovation it brings."

Today's prices seem especially high, given that the new targeted therapies don't actually cure cancer, says Jerome Kassirer, former editor of The New England Journal of Medicine and author of On the Take: How Medicine's Complicity with Big Business Can Endanger Your Health

"Families could end up spending their fortunes for what turns out to be a minor benefit," Kassirer says.

As the number of targeted therapies increase, more patients are facing this decision. Almost 200,000 patients could soon be eligible for the drug Avastin if it's approved for lung and breast cancers, two of the most common malignancies, according to Genentech.

David Johnson, former president of the American Society of Clinical Oncology, says a few of his patients are turning down care because of the cost. Johnson, who has treated cancer for 25 years, notes, "That never used to happen."

All those years in medicine, though, also have made Johnson optimistic about targeted therapies, in spite of their high prices. A handful of his lung cancer patients have done remarkably well on Tarceva, he says, although patients overall live only two months longer than those on placebos.

"Some folks tend to hype any therapy that is new," Johnson says. "Reality always tends to center us."

Although he is glad new cancer drugs are available, Saltz says, doctors had hoped that targeted drugs would replace chemotherapy, making cancer treatment gentler.

But unlike Gleevec, many of the new drugs work only when combined with chemo, he says. Adding drugs such as Erbitux and Avastin to older therapies increases costs as well as side effects.

Patients today still don't live very long on most of the new medications. Survival for patients with advanced colon cancer has increased from one year to about two years over the past decade, Saltz says. Patients with only two years to live may see that as major progress, he says.

"The drug companies have been trying to put the word 'breakthrough' in my mouth since 1995," Saltz says. "But it's far too flattering to say we've made significant progress. ... The vast majority of targeted drugs are a long way from what we hoped they would be."

Industry leaders defend their prices. Officials from Bristol-Myers Squibb Co., which sells Erbitux, note that patents offer companies a limited amount of time to recoup their investments.

Tony Plohoros, a company spokesman, says the company respects the decisions of patients who opt not to use Erbitux. "That is a personal decision up to each individual patient and their loved ones," Plohoros says.

Administrators at public hospitals with limited budgets, such as Atlanta's Grady Hospital, have to make hard choices, says Otis Brawley, director of Grady Health System's Georgia Cancer Center for Excellence. Grady doctors also are considering limiting the use of Erbitux, Brawley says.

"We are constantly asking ourselves: Are we buying drugs that we really ought not to be buying?" says Brawley, a professor at Atlanta's Emory School of Medicine. "Are we going to bankrupt ourselves buying Avastin so we won't be around to treat other people?"






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