Patients will not argue with cancer experts and other doctors weighing in on the high cost of cancer drugs and treatments. To say it is out of hand is an understatement. 118 of the nation’s top cancer doctors signed on to a report urging reforms in the pricing of the drugs.

The doctors think it is time for patients to outright demand action on reform measures to bring costs down. Government health insurance programs such as Medicare should have the ability to negotiate for lower prices. Other countries do have that ability. The United States allows lobbyists to run roughshod over Congress, preventing programs from negotiating on drug prices.

Published in the Mayo Clinic Proceedings, the doctors do not mince words.

“High cancer drug prices are affecting the care of patients with cancer and our health care system,” says lead author Ayalew Tefferi, M.D., a hematologist at Mayo Clinic. “The average gross household income in the U.S. is about $52,000 per year. For an insured patient with cancer who needs a drug that costs $120,000 per year, the out-of-pocket expenses could be as much as $25,000 to $30,000 – more than half their average household income.”

The authors cite a 2015 study published in the Journal of Economic Perspectives that showed cancer drug prices have jumped an average of $8,500 per year for each of the last 15 years. That’s a per year average increase, not one over the course of the 15 years studied.

Authors of the report note the most recent cancer drug approvals, and the cost associated with each.

“In 2014, all new U.S. Food and Drug Administration (FDA) approved cancer drugs were priced above $120,000 per year of use.”

The drug industry is pushing back on the report. Robert Zirkelbach, a spokesman for PhRMA, an industry group, released a statement on the report.

“The article ignores the fact that cancer medicines represent only one-fifth of total spending on cancer treatment.”

Yeah, nice try to pivot away from the main issue, but that’s a hard sell when new drugs cost north of $100,000 annually.

He continued PhRMA’s response by dismissing the reforms recommended in the report.

“The policy proposals they recommend would, if adopted, send a chilling signal to the marketplace that risk-taking will no longer be rewarded, stopping innovation in its tracks and halting decades of progress in cancer care.”

The industry group isn’t wrong. Pharmaceutical companies pour billions into research and development for every drug. Most never make it to market, and the company is beholden to investors.

All true, but it’s time to allow insurance programs like Medicare to negotiate. They have an ever growing pool of insured. It’s time to allow that bargaining chip to mean something for the average American.

The doctors authoring the report feel cancer should be equated to the challenges that faced patients with AIDS.

“Patients should voice their concerns and take a page from the history of AIDS advocacy strategies that resulted, within decades of the start of the AIDS epidemic, in the FDA approval of more than 35 AIDS drugs that now prevent most AIDS deaths and allow patients to live normal lives, with affordable AIDS drugs available to all.”

Cancer Drug Reforms

What are the reforms cancer doctors want to see? The list isn’t exhaustive, but the experts want Congress to start here:

  • Create a way for the Food and Drug Administration to propose a fair price for new treatments
  • Allow Medicare to negotiate drug prices (it currently is forbidden to do so)
  • Allow the Patient-Centered Outcomes Research Institute, created as part of the 2010 Affordable Care Act, to include drug prices when assessing which treatments are most useful
  • Allow the importation of cancer drugs across borders for personal use
  • Pass legislation to prevent drug companies from delaying access to generic drugs
  • Reform the patent system so companies cannot prolong product exclusivity to keep prices up

All necessary reforms. Will it happen? The United States isn’t exactly known for its fast-working political system. Congress deadlocks on what the Capitol Hill cafeteria should serve. Getting them to look past lobbyists of pharmaceutical companies and pass meaningful legislation?

One can hope, but change will need to come to Capitol Hill first. The current guard of House Reps. and Senators have shown zero inclination to act on the cost of medication for cancer patients. Or for that matter, any patient.


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