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Report: High Leukemia Treatment Costs May Be Harming Patients
The increasing cost of treatments for chronic myeloid leukemia (CML) in the U.S. has reached unsustainably high levels and may be leaving many patients under-treated or untreated because they cannot afford care, according to an article in Blood, the journal of the American Society of Hematology (ASH).
CML was selected as the focus of the article because it is now considered a highly curable disease, thanks to the emergence of targeted treatment with tyrosine kinase inhibitors (TKIs). Since the introduction of TKI therapy more than a decade ago, the annual mortality of patients with CML has declined from 10%–20% in the early 2000s to 2% today, and the estimated 10-year survival of CML patients has increased from 20% to more than 80%. The management of CML has become similar to that of chronic disorders such as diabetes and hypertension, and yet a key difference remains in the extremely high cost of CML drugs, the report says.
In the article, Hagop Kantarjian, MD, and his colleagues note that newly approved CML treatments in the U.S. are priced substantially higher than older options — a consistent trend among other cancer types. For example, of the 12 drugs approved by the FDA for various cancer indications in 2012, 11 were priced above $100,000 per year. Monthly cancer drug prices today (more than $10,000 per month on average) have almost doubled from just a decade ago, when they averaged $5,000 per month, according to the authors. The overall cost burden on families is significant, as out-of-pocket cancer care-related costs comprise approximately 25% to 30% of an average annual household budget. In the authors’ opinion, cancer care-related costs contribute heavily to the unprecedented cost of health care in the U.S., now estimated at 18% of the U.S. Gross Domestic Product, compared with 6% to 9% in much of Europe.
“A major question we need to answer is how to determine the ‘right’ price for these drugs,” Kantarjian said. “In many cases, it makes sense to let the market govern the price; however, when a product is directly related to a patient’s survival over a period of years, it is critical to set a price that allows companies to profit and that ensures that patients can afford their treatment. Since CML treatments must be taken on an ongoing basis, we are concerned that the surging prices are potentially harming patients.”
Kantarjian added: “Identifying better ways to manage the cost of cancer care will require an evolution in thinking about current pricing-related policies and regulations, including those that limit price negotiation for Medicare coverage of treatments, as well as patent-related laws that limit the introduction of more affordable generic drugs.”
Source: ASH; April 25, 2013.