Study Finds Current Prices of Hematologic Cancer Drugs Are Not Justified


Key Points

  • Up to 20% of patients may forgo treatment or significantly compromise their treatment plan due to high drug costs.
  • A total of 63% of updated cost analyses had costs per additional life-year higher than the $50,000 threshold.
  • Several studies resulted in costs of $210,000 to $426,000 per additional life-year.

The costs associated with cancer drug prices have risen dramatically over the past 15 years, a trend concerning to many oncologists. In a new analysis, researchers at The University of Texas MD Anderson Cancer Center concluded that the majority of existing treatments for hematologic cancers are currently priced too high to be considered cost-effective in the United States. Their findings were published by Chhatwal et al in the journal Cancer.

Past Research

There have been substantial improvements in survival and quality of life after treatment for hematologic cancers in recent years, but drug costs have also skyrocketed. High prices have placed a significant financial burden on patients facing these diseases, especially in light of falling household income levels. In fact, past research has shown up to 20% of patients may forgo treatment or significantly compromise their treatment plan due to high drug costs.

A 2015 study by Saret et al suggesting that hematologic cancer drugs provide good value for the money raised concerns for MD Anderson researchers Jagpreet Chhatwal, PhD, Assistant Professor in the Department of Health Services Research, and Hagop Kantarjian, MD, Professor and Chair of the Department of Leukemia.

The prior study calculated cost-effectiveness for these drugs based on 29 studies of 9 treatments for hematologic cancers, including chronic myeloid leukemia, chronic lymphocytic leukemia, non-Hodgkin lymphoma, and multiple myeloma. The results indicate that these drugs provided reasonable value for their cost in the United States.

However, those cost-effectiveness calculations were performed using drug prices at the time of the original studies and often included prices from countries outside of the United States, the researchers explained. Therefore, Drs. Chhatwal and Kantarjian performed a critical reanalysis of the prior study, using current drug prices in U.S. dollars.

“We found that, in a majority of the studies, the incremental cost-effectiveness ratios were substantially higher than the previously reported values,” said Dr. Chhatwal. “This led us to the conclusion that current prices are too high to say that the drugs provide a good value for the money.”

Skyrocketing Costs

Cost-effectiveness is commonly interpreted in terms of the cost needed to gain an additional quality year of life. A threshold value of $50,000 is widely accepted, below which the treatment can be considered cost-effective.

The researchers reanalyzed 20 of the 29 studies with updated drug prices in the current U.S. market. Upon doing this, they found that 63% of those studies had costs per additional life-year higher than the $50,000 threshold. Several studies resulted in costs of $210,000 to $426,000 per additional life-year.

These findings indicate that, although the drugs may have been cost-effective originally, their current prices cannot be justified based upon improved quality of life.

One of the drugs evaluated, imatinib, was priced at $26,000 per year of therapy in 2001 and $132,000 per year in 2014. The price increase in imatinib and other drugs evaluated is not the result of new and improved versions, but instead is simply the result of rising prices charged by drug companies, explained Dr. Chhatwal.

This is not the case only for hematologic cancer drugs, but is evident across the spectrum of new cancer therapies.

“The trend for drug prices continues to go upward,” said Dr. Chhatwal. “This is very concerning, particularly for new drugs coming to market soon that are almost all priced above $100,000 per year of treatment. This is very unaffordable and unsustainable.”

Perhaps more disturbing are the long-term implications of rising prices, explained Dr. Chhatwal. Many of these drugs need to be taken daily for years to manage cancer. Current drug prices could cause extremely large financial burdens, even for the well insured.

The authors argued that many patients cannot afford the treatments and will be forced to decide between using financial resources to prolong their lives and saving money for their families in the future. They concluded that regulating the cost of new treatments, as done in many European countries, will make health care more affordable and valuable for patients and providers in the United States.

Dr. Kantarjian is the corresponding author of the Cancer article.

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.