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 The rising cost of cancer care will be in focus during the annual
meeting of the American Society of Clinical Oncology (ASCO), which
begins on Friday in Chicago. In recent years, potent new
immunotherapies and treatments that target genetic mutations
underlying cancer have successfully curbed disease in some patients.
But they have come with ever-higher price tags, raising new
questions about how much the United States, already the world's most
expensive health system, pays for medical breakthroughs.
President Donald Trump last month unveiled a "blueprint" to reduce
drug prices by promoting the entry of cheaper rivals to existing
drugs and giving private insurers more scope to negotiate prices.
The administration has since requested feedback on a wide range of
proposals, including no longer requiring Medicare, the government
health plan for the elderly, to cover all approved drugs for certain
illnesses, including cancer.
"It is a balancing act, because we do think that there should be an
ability to negotiate price, but we are always driven by our belief
that patients should not be denied the most effective drugs for
their condition," ASCO's chief executive officer, Dr. Clifford Hudis,
told Reuters.
Another idea is to change Medicare's reimbursement of
doctors including a fee calculated as a percentage of a drug's
price. Critics say the payments encourages physicians to use the
most expensive drugs. Hudis said ASCO is not opposed to changing the
formula, but argues that oncology practices will still need to be
reimbursed for handling specialized cancer medicines delivered by
infusion or injection.
ASCO, the nation's leading association of cancer physicians, said it
will publicize its full response after submitting feedback to the
Trump administration by a July 16 deadline.
EFFECTIVENESS VS PRICE
U.S. spending on cancer drugs reached almost $50 billion last year -
nearly double since 2012 - and is projected to double again to $100
billion in five years, according to IQVIA, which collects drug sales
data.
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Expensive new cancer treatments like Merck & Co's $162,000-per-year
immunotherapy Keytruda and Gilead Sciences Inc's $373,000 blood
cancer therapy Yescarta, which have helped some patients survive
previously untreatable disease, are contributing to the increase.
But so are much less effective drugs without competitors whose
prices are raised by manufacturers each year. Oncologists and other
specialists benefit by increases on drugs that are administered in
their offices.
Without percentage-based fees, oncology practices would lose "their
ability to make considerable sums off their relationship with the
pharmaceutical industry," said Dr. Peter Bach, director of Memorial
Sloan Kettering's Center for Health Policy Outcomes in New York.
ASCO and other institutions have proposed their own methods
for reducing healthcare costs, but stopped short of urging
drugmakers to lower prices. ASCO has recommended ranking drugs on
their comparative clinical value, including relative efficacy and
side effects, but not price. The group has also suggested that the
price of a cancer drug could vary depending on how effective it is
for a specific indication, or how well an individual patient fares
after the treatment.
The association does not support moving to a flat fee for treating
cancer patients, including drugs, an approach that is being used in
other specialties. That "could force providers to make suboptimal or
lower-value choices," the organization said. At ASCO's annual
meeting, which runs from June 1-5, cancer researchers will provide
new data on survival rates with Keytruda, on the emerging class of
CAR-T cell treatments for blood cancers and on genetically targeted
therapies.
Some research will address the cost question, including a comparison
of treatment costs and outcomes for colon cancer patients in the
United States and Canada.
(Reporting by Deena Beasley; Editing by Michele Gershberg and Leslie
Adler)
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