An Arm and a Leg: The Rising Cost of Cancer Drugs and Impact on Access

Abstract

Increasing cancer drug prices present global challenges to treatment access and cancer outcomes. Substantial variability exists in drug pricing across countries. In countries without universal health care, patients are responsible for treatment costs. Low- or middle-income countries are heavily impacted, with limited patient access to novel cancer treatments. Financial toxicity is seen across cancer types, countries, and health care systems. Those at highest risk include younger patients, new immigrants, visible minority groups, and those without private health coverage. Currently, cancer drug pricing does not correlate with value or clinical benefit. Value-based pricing of oncology drugs may incentivize development of higher-value medicines and eliminate excess spending on drugs that yield little benefit. Generics and biosimilars in oncology can also improve affordability and patient access, offering dramatic reductions in drug spending while maintaining patient benefit. Oncologists can promote value-based care by following evidence-based clinical guidelines that avoid low-value treatments. Researchers can also engage in value-based research that critically explores optimal cancer drug dosing, schedules, and treatment duration and defines patient populations most likely to benefit (e.g., through biomarker selection). Cancer Groundshot proposes that we improve outcomes for today's patients with cancer, including broader global access for high-value treatments, promotion of affordable cancer control strategies, and reduction of cancer morbidity and mortality through low-cost prevention and screening initiatives. Moving forward, major oncology societies recommend promoting uniform global access to essential cancer medicines and avoiding financial harm for patients as key principles in addressing the affordability of cancer drugs.

Financial burdens during the COVID-19 pandemic are related to disrupted healthcare utilization among survivors of adolescent and young adult cancers

“…Our survey questions about medication obtainment captured adaptive behaviors to find affordable medications. The cost of prescription medications in the USA rose even before the pandemic began, with cancer drugs being among the most expensive [ 30 ].…”

Recent Advances in Repurposing Disulfiram and Disulfiram Derivatives as Copper-Dependent Anticancer Agents

“…Costs of this magnitude arrest research and development, forcing pharmaceutical developers to pitch for more money or suspend development altogether. Consequently, some of these new therapies reach price tags of more than $100,000 per patient per year, but still has no "meaningful benefit" (Saluja et al, 2018;Leighl et al, 2021). The prices of cancer drugs have increased 10% every year between 1995 and 2015 due to the escalated expense of R&D in the pharmaceutical industries (Leighl et al, 2021).…”

“…Consequently, some of these new therapies reach price tags of more than $100,000 per patient per year, but still has no "meaningful benefit" (Saluja et al, 2018;Leighl et al, 2021). The prices of cancer drugs have increased 10% every year between 1995 and 2015 due to the escalated expense of R&D in the pharmaceutical industries (Leighl et al, 2021). In recent years there has been an increasing appreciation of the potential of repurposing known drugs like DSF, as an anticancer treatment.…”

“…More recently, it has been identified that even the state-of-the-art immunotherapies, such as immune check-point inhibitors and adoptive T cell therapies which revolutionised the treatment of advanced cancers, are no exception to innate and acquired resistance mechanisms in cancers (Restifo et al, 2016;Hiam-Galvez et al, 2021). Moreover, the current growth in the cost of many targeted therapies for cancer discourages their use in clinical setting in terms of cost benefit ratio evaluation by healthcare agencies (Saluja et al, 2018;Leighl et al, 2021).…”

Precision medicine and the fragmentation of solidarity (and justice)

“… 15 See Prasad ( 2017a , b ); Leighl et al ( 2021 ). Leighl et al write, “Across Europe, there are large variation in access to novel cancer medicines, with less developed countries in Eastern Europe reporting the greatest limitations” (at e2).…”