New Study Questions Cost of Blood Cancer Drugs

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Researchers at The University of Texas MD Anderson Cancer Center say it is time to regulate the cost of new treatments for blood cancers, in a similar fashion as European countries. They have just published a new analysis in the June 22, 2015 issue of Cancer that suggests current blood cancer drug prices are not justified and it is time to call for significant change.^{1, 2}

The new analysis showed that the majority of new treatments for hematologic cancers are too high to be deemed cost-effective in the United States.  A 2015 report suggesting that hematologic cancer drugs provide good value for money raised concerns for study lead author Jagpreet Chhatwal, PhD, and his colleague Hagop Kantarjian, MD, who are both with MD Anderson Cancer Center in Houston.

The prior study calculated cost-effectiveness for these drugs based on 29 studies of nine treatments for hematologic cancers, including chronic myeloid leukemia (CML), chronic lymphocytic leukemia (CLL), non-Hodgkin lymphoma (NHL), and multiple myeloma (MM). The results indicate that these drugs provided reasonable value for the money in the US. However, the Texas researchers found that 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 US.  

Dr. Chhatwal and colleagues performed a critical reanalysis of the prior study using current drug prices in US dollars. “We found that in a majority of the studies the incremental cost-effectiveness ratios (ICERs) were substantially higher than the previously reported values,” said 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.”

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 were able to reanalyze 20 of the 29 studies with updated drug prices in the current US market. 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, many times higher than conventionally accepted levels.

One of the drugs evaluated, imatinib (Gleevec), 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, noted Chhatwal. 

The study authors would like to see government regulation of new treatments for hematologic cancers in the same fashion as many European countries. Chhatwal said more and more patients are experiencing financial toxicity due to extremely large financial burdens. A 2014 study found that up to 20% of hematologic cancer patients may forgo treatment or significantly compromise their treatment plan due to high drug costs.

References:

• Chhatwal J, Mathisen M, Kantarjian H. (2015). Are high drug prices for hematologic malignancies justified? A critical analysis. Cancer.
• The University of Texas MD Anderson Cancer Center. (2015). Current blood cancer drug prices not justified, MD Anderson study finds.