Cancer drug costs are skyrocketing – this we know. But what if we’ve got a distorted view of the overall picture of cancer costs? That’s the argument of Dr. Andrew Pecora, an oncologist and chief innovation officer at the John Theurer Cancer Center at Hackensack University Medical Center.
There’s been a lot of talk swirling around why these cancer drug costs continue to increase. Take the recent Wall Street Journal article, “Doctors Object to High Cancer Drug Prices,” in which more than 100 oncologists spoke out in a Mayo Clinic medical journal article on the ever-rising costs to patients. The biopharma industry is bearing the brunt of criticism for these costs – because incremental increases in outcomes aren’t matching up with the exorbitant increases in cost.
But Pecora said we’re missing the big picture here – that while cancer drug costs are on the rise, we aren’t taking into account the overall cost of care, or the individual benefit on a patient’s life.
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“There’s no doubt about it – rising costs are an area of concern,” Pecora said. “It has to be talked about, but it has to be put in context of the total cost of cancer care.”
Pecora says that cancer drug costs account for about 40 percent of a cancer patient’s medical bills. The rest go to hospital stays, doctors’ fees, testing and so on. We need to examine where the cancer drug costs fit into this overall situation, and
Pecora cited Sovaldi as an example of rising costs being validated by the outcome – the breakthrough drug does, indeed, cure Hepatitis C despite its steep $84,000 price tag. This idea should be extrapolated to cancer care, he said.
“I’m not justifying the cost of the drug, and I’m not defending the pharmaceutical industry,” Pecora said. “My interest is that the proper argument is not being waged. You have to focus on the total cost of care – not just the drugs.”
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Rather than fixating on the costs of a drug that can extend life, on average, three to six months – it’s a matter of looking at the likelihood of that drug extending a patient’s life by a year. Or two years. Every patient is different, as seen in this drive toward precision medicine in our health system.
His point? We’re all kevetching about these rising costs – and that’s fair. But we’re missing the underlying point of providing the best possible treatment – because there are absolutely cases when these steep costs are justified. A better way to evaluate cancer costs is to look at the entire cost to the patient, and align that with improvement to a patient’s health.
“The idea that we can set a top-down policy of what’s appropriate or not is very dangerous,” Pecora said. “We can’t let the system bankrupt the country – but there’s a way through the middle, I think.”