Dear Big Pharma,

Are you sure you’re charging cancer patients enough for medications?

If you’re a cancer patient using one the new miracle drugs you already know about costs. Just for the record, I am very happy that big drug companies develop, test, and produce new cancer treatment drugs. It’s the price that raises questions.

Recently a group of more than 100 oncologists specializing in chronic myeloid leukemia (CML) co-authored an article in the American Society of Hematology Journal Blood http://www.hematology.org/News/2013/10454.aspx questioning the need for and ethics of drug companies charging patients $100,000 or more a year for medications. Drug companies need to cover their research costs—and make reasonable profits.

A major sponsor of the article was Dr. Brian Druker, Director of the Knight Cancer Institute at Oregon Health and Science University in Portland, Oregon. Dr. Druker was the main developer of one of the drugs in question, Gleevec. This drug has been very successful for patients with CML for more than 10 years. Although he gets nothing for developing the drug, the drug company that manufactures and sells the drug has systematically increased the cost of Gleevec from about $30,000 a year in 2001 to about $100,000 a year in 2013. The result is billions in profits. You’d think prices would go down after all the startup and research costs were covered. These oncologists hope to open a useful dialog with the drug companies. Curiously, these expensive drugs cost much less in most other countries.

The same cost concerns exist for all cancer drugs, including prostate cancer drugs. Several prostate cancer drugs have recently been approved, e.g. Provenge and Zytiga. Both cost patients about $100,000 a year. Some prostate cancer patients will not be able to afford the new medications. Patients with drug coverage are charged a co-pay which can be as much as $2000 or $3000 a month. Without drug coverage, patients are responsible for the entire amount. Some drug companies do provide free or reduced cost medications for a very few low income patients.

The FDA approved 12 cancer drugs in 2012. Eleven of them are priced above $100,000 a year. Some drugs are more successful than others but that doesn’t seem to impact the price very much.

Should drug costs to patients be capped? Should costs be related to patient income? Should drug companies charge as much as ‘traffic will bear’? Is there a fair price where drug companies make profits and patients have access to drugs they need to stay alive?

I have a very personal interest in this debate, or as my old neighbor would say, ‘I’ve got a dog in the hunt’—I just graduated to one of the super expensive drugs. I have learned a lot about drug co-pay assistance, Part D coverage from beginning to donut hole to catastrophic coverage (it’s more complicated than you’d think). It is estimated that about 10% of cancer patients do not take needed medications because of cost. Dr. Tomasz Beer, Deputy Director of the Knight Cancer Institute (and my oncologist) put it this way, “it kind of takes the wind out of your sails when you see your patients not being able to afford them (life saving drugs).”

It will be interesting to see what will happen with drug costs. I won’t hold my breath waiting for prices/co-pays to go down—but you never know. Maybe some pigs DO fly.

I did not mention the name of the pharmaceutical companies who manufacture the drugs mentioned in this article. If you’re interested, just Google the drug name.

axman