At Face Value

At Face Value ImageThe recent 60 Minutes episode on the “eye popping” cost of cancer drugs painted pharmaceutical manufacturers and community oncologists as greedy scoundrels only interested in making huge profits at the expense of desperate cancer patients.

Reporter Lesley Stahl keyed in on a common target in the debate over rising healthcare costs—drug price, and a new term being used by oncologists: “financial toxicity.”  The program singled out ziv-aflibercept (Sanofi-Aventis) as a high-priced agent for metastatic colorectal cancer that cut its price in half only after three doctors at Memorial Sloan Kettering wrote a negative op-ed article in the New York Times suggesting that manufacturers determine drug prices similar to how one shops in a Turkish bizarre.

To emphasize the industry’s greed, the producers highlighted imatinib (Novartis), and although they acknowledged it was indeed a true advance in the treatment of chronic myeloid leukemia when it was approved, they chose to focus only on how the price has more than tripled over the past decade despite the availability of several newer, more effective treatment options.

Media coverage like this, along with ongoing policy discussions, continue to focus on whether the cost of new cancer therapies is putting urgently needed, life-saving therapy out of the reach of patients.

The Personal Side

Ogilvy CommonHealth Worldwide supports a number of organizations, including a number focused on cancer and oncology patients. One such nonprofit is the Cancer Research Institute (CRI), an organization founded in 1953 and dedicated to harnessing the power of the body’s own immune system to conquer cancer. Through their efforts, and the efforts of other institutions like them, a promising new class of therapy called immune-oncology (IO) has emerged.

Think about that—over six decades of research, funding, clinical trials, and education has led to some of today’s most promising IO agents. I imagine there are a lot of lost bets along the way; despite the millions of dollars that go into the research and development of new cancer treatments, only 13% of all compounds in development are ever approved for use in patients.1

But through the perseverance, commitment and investment of many, including the pharmaceutical manufacturers, what today is a reality would not have been possible.

I had the opportunity to attend CRI’s annual event and had the pleasure of meeting many post doc fellows and researchers, and I can assure you the value they saw in their work was not the profit their research would have for their companies, but the life-saving impact it would have for patients urgently awaiting new treatments.

One such person I met at the CRI event was “Sue,” a young woman recently married and living with a rare form of cancer (angiosarcoma) diagnosed in less than 300 people per year. She told me about how appreciative she was of the funding from CRI, manufacturers, and industry to the work she was doing and the hope that she’ll one day play a role in helping cure people like herself living with a deadly form of cancer.

Which made me think… If manufacturers and nonprofit organizations like CRI did not sustain the commitment and investment (in the billions) in search of new therapies, including areas of rare disease, what would become of patients like Sue, without the combined efforts and commitment of these institutions?

The Flip Side

So today, patients are being asked to absorb a larger portion of their prescription costs as a result of more aggressive payer cost management and growing pressure on healthcare budgets overall.

However, it’s important to recognize the overall savings to the system cannot be recognized in terms of savings for a patient individually. And the true value of cancer medicines goes well beyond the cost of a particular drug.

R&D of novel treatments has the potential to not only help patients today, but also provide longer-term value by investing in therapies for tomorrow. By limiting our view to a short-term cost savings approach, the potential to develop new, innovative treatment approaches, like IO, may never occur.

So when considering the price of drugs, remember this reflects the cost and risk of medicine development, the complexity inherent in treating cancer, as well as value to the patient, the healthcare system, and to society. So don’t take price at face value!

The Rest of the Story

So while the producers of 60 Minutes focused solely on the “devastating” side effect of cancer (the bill), a far worse side effect would be if manufacturers chose to cut the amount (billions) they now invest at risk to commercialize new therapies. This would be especially detrimental in rare disease areas like angiosarcoma, where the investment will outweigh the profit—and ultimately the patient would have the most to lose.

Through an environment and policy framework incentivizing and rewarding research, a healthy competitive environment will pave the way for new advances so desperately needed, and everyone benefits.

One thing is for certain, the path forward should focus on continued (albeit targeted) investments, improving access to these important oncolytic advances, development of biosimilars, and for crying out loud, doing a better job communicating the value proposition (aka, demonstrate product value) of emerging therapies to providers, payers AND patients.

Reference: 1. DiMasi A, Reichert JM, Feldman L, Malins A. Clinical approval success rates for investigational cancer drugs. Clin Pharmacol Ther. 2013;9(13):329-335.

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