Actual costs of cancer drugs in 15 European countries

Harten, Willem H. van; Wind, Anke; Paoli, Paolo De; Saghatchian, Mahasti; Oberst, Simon

doi:10.1016/s1470-2045(15)00486-6

Cited by 83 publications

(64 citation statements)

References 8 publications

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“…European data indicate that actual prices can be as much as 58% lower than list price. 29 Our analysis therefore overestimates expenditures, but the magnitude of this effect is unknown owing to the confidential nature of these negotiated pricing agreements.…”

Section: Limitationsmentioning

confidence: 85%

Cancer drug expenditure in British Columbia and Saskatchewan: a trend analysis

Pataky

Tran

Coronado

et al. 2018

cmajo

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Background: Expenditure on systemic therapy for cancer has been increasing quickly owing to population growth, increased use, both in the number of users and in prescription volume, and rising drug prices. Our objective was to describe trends in expenditure in British Columbia and Saskatchewan's cancer care systems and to elucidate these drivers of growth. Methods:In this trend analysis, we obtained pharmacy dispensing records from the BC Cancer and Saskatchewan Cancer Agency pharmacies for all anticancer therapies dispensed in 2006-2013. We calculated total annual expenditure directly from the data and conducted a trend analysis of crude and standardized annual expenditure using generalized linear models. We estimated trends in the following components of total expenditure: cancer incidence, number of systemic therapy users per incident case, number of dispensed prescriptions per user and cost per prescription. Analysis was stratified by patient age group, cancer site and route of administration (oral or intravenous/other).Results: Expenditure on systemic therapies, adjusted for population growth and aging, increased an average of 9.2% (95% confidence interval [CI] 7.2 to 11.2) per year in Saskatchewan and 6.4% (95% CI 5.3 to 7.6) per year in BC. Growth in expenditure on orally administered agents was more than 2 times higher than growth in expenditure on intravenous/other agents. Growth rates varied significantly by cancer site. In both provinces, rising cost per prescription was the largest contributor to overall growth. Interpretation:Price is the primary driver of growth in systemic therapy expenditure in both BC and Saskatchewan. Understanding the mechanisms of expenditure growth may inform system planning and support policy-makers' efforts to manage rising costs. AbstractResearch OPEN CMAJ OPEN, 6(3) E293Research in BC and Saskatchewan to better understand variation between provinces while minimizing differences due to funding structure. The objectives of the study were to describe trends in systemic therapy use and cost in BC and Saskatchewan from 2006 to 2013, by therapy type and cancer site, and to identify key drivers of overall growth by isolating trends in demographic profile, incidence, use and cost. Methods Data sourcesWe conducted secondary analysis of routinely collected administrative data from the Saskatchewan Cancer Agency and BC Cancer. In this context, secondary analysis refers to analysis of data that were not collected for research purposes.Both agencies provide population-based cancer care services, including complete universal coverage of systemic therapy provided according to agency guidelines. 12,13 We obtained data from the BC Cancer Systemic Therapy Program and the Saskatchewan Cancer Agency Pharmacy System for all prescriptions dispensed in 2006-2013. These databases contain dispensing records for all systemic therapy delivered to patients with cancer in the province and are routinely reviewed by pharmacy staff for accuracy and quality assurance. Records for clinical trials, speci...

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Section: Limitationsmentioning

confidence: 85%

Cancer drug expenditure in British Columbia and Saskatchewan: a trend analysis

Pataky

Tran

Coronado

et al. 2018

cmajo

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“…Recently, a number of papers and commentaries in Lancet Oncology have highlighted not only the increasing costs of cancer medicines, but also their unequal pricing in different countries/regions [33,34,35]. Vogler et al [33] evaluated the prices of 31 cancer drugs in 16 higher-income European countries, and in Australia and New Zealand.…”

Section: Cost Pricing and Value: A Triple-edged Swordmentioning

confidence: 99%

“…It should be noted that these prices do not include payer-negotiated discounts. In relation to this particular issue, van Harten et al [34] found through a survey of members of the Organisation of European Cancer Institutes (OECI) and Cancer Core Europe, which included 21 respondents from 15 European countries, that the difference between the list price and the actual price could vary significantly, with an actual price as low as 58% of the list price.…”

Section: Cost Pricing and Value: A Triple-edged Swordmentioning

confidence: 99%

Shooting for the Moon or Flying Too Near the Sun? Crossing the Value Rubicon in Precision Cancer Care

Lawler¹,

French

Henderson³

et al. 2016

Public Health Genomics

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In his last two State of the Union addresses, President Barack Obama has focused on the need to deliver innovative solutions to improve human health, through the Precision Medicine Initiative in 2015 and the recently announced Cancer Moonshot in 2016. Precision cancer care has delivered clear patient benefit, but even for high-impact medicines such as imatinib mesylate (Glivec) in chronic myeloid leukaemia, the excitement at the success of this practice-changing clinical intervention has been somewhat tempered by the escalating price of this ‘poster child' for precision cancer medicine (PCM). Recent studies on the costs of cancer drugs have revealed significant price differentials, which are a major causative factor behind disparities in the access to new generations of immunological and molecularly targeted agents. In this perspective, we will discuss the benefits of PCM to modern cancer control, but also emphasise how increasing costs are rendering the current approaches to integrating the paradigm of PCM unsustainable. Despite the ever increasing pressure on cancer and health care budgets, innovation will and must continue. Value-based frameworks offer one of the most rational approaches for policymakers committed to improving cancer outcomes through a public health approach.

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“…Cancer care consumes up to 30% of total hospital expenditure across Europe, 6 and spending on cancer treatment has risen faster than spending in many other areas of healthcare, with costs continuing to rise considerably. 7,8 However, despite this, the share of healthcare expenditure allocated to cancer remains significantly lower than the share of the cancer disease burden (Figure 1).…”

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confidence: 99%

Can we Continue to Afford Access to Cancer Treatment?

Wilking¹,

Lopes²,

Meier³

et al. 2017

European Oncology &Amp; Haematology

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O ncology is facing a crisis of affordability that is not sustainable. The economic burden of cancer is growing, as a result of the rising cancer incidence and increased survival, alongside growing investment in disease prevention, diagnosis and treatment. The prices of new cancer drugs continue to increase, placing growing pressure on many healthcare systems. The aim of this article is to explore the reasons why the cost of cancer care is increasing, and why this increase may become unsustainable unless changes are made. There are only limited options for future health spending. Finding ways to improve the allocation of existing resources to achieve the best outcomes for patients will be key to achieving sustainability, whilst safeguarding the continued development of new, effective cancer treatments. Currently, too many cancer drugs are approved without robust evidence of value, and spending more on treatments does not necessarily translate to improvements in health. For all new drugs, in addition to efficacy and safety, there should be a focus on value, with measured outcomes and pricing that ensures these drugs are affordable. Fundamental changes to healthcare systems and industry are needed to sustain cancer care and allow continued access to effective and safe treatments for all patients.

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Actual costs of cancer drugs in 15 European countries

Cited by 83 publications

References 8 publications

Cancer drug expenditure in British Columbia and Saskatchewan: a trend analysis

Cancer drug expenditure in British Columbia and Saskatchewan: a trend analysis

Shooting for the Moon or Flying Too Near the Sun? Crossing the Value Rubicon in Precision Cancer Care

Can we Continue to Afford Access to Cancer Treatment?

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