Cost of Cancer Drugs Does Not Always Align with Clinical Benefit

A new study examined the cost-benefit of cancer drugs and found no correlation between the two.

“Our study clearly shows that, in general, for Switzerland, Germany, England and the United States, there is no association between clinical benefit of a cancer drugs and their prices,” lead study author Kerstin Vokinger, MD, explained in a press release. “It’s also clear that the prices of cancer drugs in the US are significantly higher than in the four European countries, with Americans paying on average approximately twice as much for the same drug.”

To conduct their study, the researchers investigated all new drugs with initial indications for adult cancers given U.S. Food and Drug Administration approval between Jan. 1, 2009, and Dec. 31, 2017; for the European Medicines Agency, approvals through Sept. 1, 2019, were examined. They used the American Society of Clinical Oncology-Value Framework (ASCO-VF) and European Society for Medical Oncology-Magnitude of Clinical Benefit Scale (ESMO-MCBS) to analyze drugs indicated for solid tumors, comparing monthly drug treatment costs between benefit levels with hierarchical linear regression models. The Spearman’s correlation coefficients were calculated between costs and benefit levels for the U.S., England, Switzerland, Germany, and France.

Final analysis included 65 drugs, most of which (n=47, 72%) were approved for solid tumors; 18 (28%) were approved for hematological malignancies. Monthly drug treatments cost a median 2.31 times more in the U.S. compared to the European countries. Monthly treatment costs for solid tumors were not correlated with clinical benefit in all five countries when using the ESMO-MCBS (P=0.16 for the U.S., P=0.98 for England, P=0.54 for Switzerland, P=0.52 for Germany, and P=0.40 for France); the same was true when using the ASCO-VF, except for France (P=0.56 for the U.S., P=0.47 for England, P=0.26 for Switzerland, P=0.23 for Germany, and P=0.037 for France).

The study was published in The Lancet Oncology.

Dr. Vokinger, a professor at the University of Zurich, said, “The pricing of cancer drugs is only partially justified. Drugs that are less effective should be cheaper than those with high efficacy.”

She added, “National authorities should take greater account of the clinical benefits of drugs when negotiating prices, and therapies that provide high clinical benefit should be prioritized in price negotiations.”