Development and economic trends in cancer therapeutic drugs: a 5-year update 2010–2014

Abstract

Background:Over the past 20 years, the mechanisms of action, duration of benefits and economic costs of newly licenced cancer drugs have changed significantly; however, summary data on these characteristics are limited.Methods:In this study, using historical copies of the British National Formulary and relevant contemporary publications, we have documented for each new cancer drug the year of introduction, therapeutic classification, initial indication, median duration of treatment and the cost of treatment at introduction relative to the then current UK GDP per capita.Results:Before 2000, there were 69 cancer treatment drugs available, of which 50 (72.5%) were classical cytotoxic drugs. In the subsequent 15 years, there have been 63 more new cancer treatment drugs added, including 20 kinase inhibitors and 11 monoclonal antibodies. The average median duration of treatment with a new drug has risen from 181 days in 1995–1999 to 263 days in 2010–2014. The average cost of treatment has also risen from £3036.91 (20.6% of UK per capita GDP) in 1995–1999 to £20 233 (89.0%) in 2005–2009 and now to £35 383 (141.7%) in 2010–2014.Conclusions:The last 5 years has seen 33 new cancer drugs. These drugs deliver significant benefits in patient outcomes and are taken for increasing lengths of time. Alongside these clinical benefits, the direct costs of new treatments have increased significantly over the past decade.

Estimated generic prices of cancer medicines deemed cost-ineffective in England: a cost estimation analysis

“…These prices have begun to pose problems in high-income settings too: newer drugs are a major contributor to the 10-fold increase in the average cost of cancer treatment in the UK since 1995 6. Drug prices account for roughly a quarter of all cancer costs and prices have increased 10 times in the past decade 7.…”

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

“…Between 2005 and 2014, most new oncology drugs were for rarer indications, including renal cancer, lymphoma and chronic myelogenous leukemia. 8 Growth in total expenditure …”

“…7 The number of new drugs being approved has accelerated alongside higher daily drug costs and longer duration of treatment. 8 The use of orally administered drugs in an outpatient setting has also been a major change. Unlike conventional intravenous cytotoxic chemotherapy, with high-dosage infusions on intermittent schedules, many orally administered agents are delivered at a lower daily dosage over a prolonged period.…”

Cancer Referral and Treatment Activity 2010–2015: A Population-Based Study from Vancouver Island

“…Since the early 2000s, a major increase in the number of cancer drugs available has occurred, with more than 50 new agents introduced 1 .…”

“…However, only a few of the new drugs have directly replaced a pre-existing therapy, and the overall outcome has been to increase the number of lines of treatment available for many patients. As a result, it is likely that the volume of cancer treatment delivered will increase substantially, potentially leading to financial and organizational challenges 1,2 . The economic issues associated with funding new cancer drugs have been well documented in the medical and political literature 3,4 .…”