Market spiral pricing of cancer drugs

Light, Donald W.; Kantarjian, Hagop

doi:10.1002/cncr.28321

Cited by 84 publications

(69 citation statements)

References 8 publications

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“…The relatively rapid approval of these pricey new medications has skyrocketed costs: many new oral cancer therapies cost more than $100,000 USD. 10 The finding that 70% of practice pattern variability was unrelated to Part D variability also deserves attention. The decision to prescribe a particular medication is subject to physician preference, which can be influenced by comfort with the medication and side effects.…”

Section: Medicare-associated Disparitiesmentioning

confidence: 99%

Disparities in Adjuvant Endocrine Therapy

Cathcart-Rake¹,

Ruddy²

2017

J Natl Compr Canc Netw

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Multiple competing factors (economic, environmental, social, and personal) influence health outcomes. For many patients, the lack of adequate insurance coverage is an obstacle to timely and appropriate medical care. Cancer survivors may be particularly vulnerable to the ill effects of insufficient insurance benefits. In one recent study comparing cancer survivors with their unaffected siblings, cancer survivors were more likely to lack employer-sponsored coverage, have been denied coverage, have Medicaid, and have high out-of-pocket costs. They were also more likely than their siblings to borrow money for medical expenses, worry that they would not receive a medical procedure, and not fill a prescription.1 Uninsured survivors suffered even greater disparities when compared with insured survivors, and were less likely to have a primary care provider or fill a prescription, and more likely to postpone preventive care. Medicaid-Associated DisparitiesInsufficient Medicaid benefits have frequently been implicated in the cancer-related medical disparities that are attributed to inadequate insurance. Although states are mandated to pay for certain aspects of care, such as inpatient hospital services, coverage for other needs (eg, prescription medications and colorectal cancer screening) varies by state.2 Consequently, patients who are uninsured or covered under Medicaid are more likely to be diagnosed with breast and colon cancer at later stages (stage III and IV), 3 and those with melanoma who have Medicaid are also more likely to experience surgical delays. 4 In addition, in one study of patients with breast, colorectal, lung, and prostate cancers and non-Hodgkin's lymphoma, those who were uninsured and those insured by Medicaid had a significantly higher risk for death within 5 years of diagnosis than privately insured patients after adjusting for sex, age, race/ethnicity, marital status, socioeconomic status, and disease stage. 5 Similarly, another large retrospective study of 976,178 women diagnosed with breast cancer showed that payer status was a statistically significant predictor of survival after adjusting for tumor stage, age, race, comorbidities, education, distance traveled for treatment, cancer program, diagnosing/treating facility, and treatment delay. Medicare-Associated DisparitiesAlthough Medicare, as opposed to Medicaid, does require states to cover more comprehensive adult cancer screening, Part D prescription drug coverage still varies from state to state.2 Inadequate Medicare Part D coverage may cause patients to stop taking life-saving therapies. In one large study of prescription fill rates among 10,302 women diagnosed with early-stage breast cancer and who were prescribed hormonal therapy, 24% were "nonadherent," meaning that they possessed <80% of the number of pills that would be required for continuous therapy between their first and last prescription (termed the "medication possession ratio"), and patients with Medicare were less likely to be adherent than those with commercial insurance ...

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Section: Medicare-associated Disparitiesmentioning

confidence: 99%

Disparities in Adjuvant Endocrine Therapy

Cathcart-Rake¹,

Ruddy²

2017

J Natl Compr Canc Netw

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“…High prices of new medicines are not always associated with high benefits (Howard et al 2015;Light and Kantarjian 2013). For examples many new cancer drugs provide limited additional benefits over existing ones.…”

Section: High Prices Are Not Always Justified By High Benefitsmentioning

confidence: 99%

“…treatment for Medicare patients has increased from USD 97 in 1965-1969to USD 7112 in 2005-2009 and increased further over the recent years (Figure 16). In the United States, 12 out of 13 cancer drugs approved in 2012 cost more than USD 100 000 per year (Light and Kantarjian 2013). These price increases are observed everywhere.…”

mentioning

confidence: 99%

Pharmaceutical Expenditure And Policies

Belloni

Morgan

Paris

2016

OECD Health Working Papers

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All Health Working Papers are now available through the OECD's Internet Website at http://www.oecd.org/els/health-systems/health-working-papers.htm JT03394302 Complete document available on OLIS in its original formatThis document and any map included herein are without prejudice to the status of or sovereignty over any territory, to the delimitation of international frontiers and boundaries and to the name of any territory, city or area. This series is designed to make available to a wider readership selected health studies prepared for use within the OECD. Authorship is usually collective, but principal writers are named. The papers are generally available only in their original language -English or French -with a summary in the other.The statistical data for Israel are supplied by and under the responsibility of the relevant Israeli authorities. The use of such data by the OECD is without prejudice to the status of the Golan Heights, East Jerusalem and Israeli settlements in the West Bank under the terms of international law.This document and any map included herein are without prejudice to the status of or sovereignty over any territory, to the delimitation of international frontiers and boundaries and to the name of any territory, city or area. ABSTRACTAcross OECD countries, pharmaceutical spending reached around USD 800 billion in 2013, accounting for about 20% of total health spending on average when pharmaceutical consumption in hospital is added to the purchase of pharmaceutical drugs in the retail sector. This paper looks at recent trends in pharmaceutical spending across OECD countries. It examines the drivers of recent spending trends, highlighting differences across therapeutic classes. While the consumption of medicines continues to increase and to push pharmaceutical spending up, cost-containment policies and patent expiries of a number of top-selling products have exerted downward pressure on pharmaceutical expenditures in recent years. This resulted in a slower pace of growth over the past decade.The paper then looks at emerging challenges for policy makers in the management of pharmaceutical spending. The proliferation of high-cost specialty medicines will be a major driver of health spending growth in the coming years. While some of these medicines bring great benefits to patients, others provide only marginal improvements. This challenges the efficiency of pharmaceutical spending.

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“…Little correlation is evident between the actual efficacy of a new drug and its price as measured by cost-efficacy ratios 9,[20][21][22] . For example, in advanced pancreatic cancer, erlotinib has demonstrated a 0.33-month median improvement in survival at an estimated incremental cost of about $500,000 per life-year gained.…”

Section: Value-based Carementioning

confidence: 99%