Price of cancer drugs called ‘mind-boggling’

Although new cancer therapies have nearly doubled the life expectancy for those with advanced colorectal cancer, their staggering costs may keep the drugs out of reach for some patients, according to an editorial in today’s New England Journal of Medicine.

With older chemotherapy regimens, patients with advanced disease lived an average of one year, at a cost of $63 for an initial eight-week treatment. A newer drug regimen has extended survival to 21 months, but at a cost of $12,000, the editorial says.

Drugs such as Erbitux and Avastin, approved in February, may allow patients to live even longer. Adding Avastin to standard chemotherapy, however, raises the price to $21,000; Erbitux combinations bring the total to $31,000, according to the article, written by Deborah Schrag of Memorial Sloan-Kettering Cancer Center in New York. Treating all 56,000 Americans with advanced colorectal cancer could total $1.2 billion.

“It’s mind-boggling,” Schrag says. “We’re so happy we’re making progress. But why does it have to cost so much?”

8-week treatment, upward of $30,000
The cost of an eight-week chemotherapy course for advanced colorectal cancer has risen dramatically in recent years. New drugs are more expensive, and patients today often take several at a time.

Drug and year that therapy came into use Cost (+1)

  • 5-FU (5-fluorouracil) and leucovorin (Wellcovorin), 1991 $63
  • Irinotecan (Camptosar), 1996 $9,497
  • Oxaliplatin (Eloxatin), given with leucovorin and 5-FU, 2002 $11,889
  • Bevacizumab (Avastin), with leucovorin, 5-FU, irinotecan, 2004 $21,399
  • Cetuximab (Erbitux), with irinotecan, 2004 $30,790

    • 1 — Drug costs represent 95% of average wholesale price in May 2004

    Source: Deborah Schrag, Memorial Sloan-Kettering Cancer Center

    Even patients with insurance may be hard-pressed to afford the drugs, she says. Insurance companies may need to raise premiums to cover the expense.

    Leonard Saltz, a leading colon cancer researcher at Memorial-Sloan Kettering, says therapy today costs more partly because patients are living longer and taking drugs for years, rather than weeks.

    New cancer therapies are also more complicated to make, says Sue Hellmann, president of product development at Genentech, which makes Avastin. Researchers spent 15 years developing Avastin, she says. While Avastin increases the price of therapy when used with other drugs, its individual cost is about the same as other chemo medications, she says.

    A spokeswoman for Bristol-Myers Squibb Co., which markets Erbitux, says its price reflects the costs of ongoing and future clinical trials.

    Doctors were initially enthusiastic about Erbitux and Avastin because they cause few of the harsh side effects caused by conventional chemotherapy. But some have been disappointed, Saltz says, that because the drugs work best when combined with these traditional drugs, patients are not spared the nausea and vomiting long associated with cancer treatment.

    Some experts expect some costs to drop. Some newer drugs come in pill form, which cost less to administer than infusions.

    The United States may need to consider a new system for pricing cancer drugs, Schrag writes. She notes that the Centers for Medicare and Medicaid Services, the nation’s largest purchaser of health care, is not allowed to negotiate prices with drug companies.

    “We’re reaching the point where, as a society, we are going to have to confront the costs,” Saltz says.

    Written by Liz Szabo for USA Today, and published on DrKelley.info, July 22, 2004. Embedded links may no longer be active (Ed. 12.27.10)

    FAIR USE NOTICE: This site contains copyrighted material the use of which has not always been specifically authorized by the copyright owner. We are making such material available in our efforts to advance understanding of environmental, political, human rights, economic, democracy, scientific, and social justice issues, etc. We believe this constitutes a ‘fair use’ of any such copyrighted material as provided for in section 107 of the US Copyright Law. In accordance with Title 17 U.S.C. Section 107, the material on this site is distributed without profit to those who have expressed a prior interest in receiving the included information for research and educational purposes. For more information go to: http://www.law.cornell.edu/uscode/17/107.shtml