ASCO tackles a tough question: When is a cancer drug too pricey?

ASCO Chief Medical Officer Richard Schilsky

When the American Society of Clinical Oncology revealed in March that it planned to rate cancer drugs on a variety of factors, including their prices, drugmakers had good reason to worry. ASCO, after all, is run by oncologists--the very physicians Big Pharma relies upon to turn new cancer drugs into blockbusters. But as ASCO Chief Medical Officer Richard Schilsky explained when the initiative was launched, the high prices on many cancer drugs are unsustainable, so the organization wants to provide oncologists with a scorecard they can use to determine when the benefits of a drug don't justify its cost.

The first hints of how that scorecard is shaping up will be revealed starting today, at the annual ASCO conference in Chicago. Researchers who review results of trials being presented at the meeting have, in some cases, been asked to scrutinize the value of those drugs, according to Bloomberg. The conference will also feature panel discussions offering viewpoints on cost from patients, insurance executives, drug companies and foreigners from countries that have strict cost constraints.

Skyrocketing drug costs have long been a concern, particularly in cancer. A study released earlier this month by the IMS Institute for Healthcare Informatics revealed that global oncology spending hit $91 billion in 2013 and it's growing at a 5% annual rate. Cancer treatments in the U.S. now cost $10,000 a month on average, up from $5,000 just a year ago, IMS said. And a 2013 paper published in the journal Health Affairs found that cancer patients face a 2.65 times higher risk of bankruptcy than healthy people, according to Bloomberg.

Bloomberg highlights the story of Chris Tribble, a colon cancer patient at the Duke Cancer Institute, who told his oncologist he could no longer afford to pay the $325-per-week copay for the drug he was prescribed. So the doctor, Yousuf Zafar, switched him to an equally effective drug with no copay. Tribble is now cancer-free, and Zafar says he has learned to check with pharmacies before he prescribes pricey drugs and to offer choices and copay assistance to patients. A 2013 study spearheaded by Zafar found that 45% of patients who applied for copay assistance skipped doses or did not properly fill prescriptions for cancer drugs due to cost, according to Bloomberg.

It isn't just oncologists who are worried about drug prices. In April, physicians attending the European Association for the Study of the Liver conference in London debated the value of Sovaldi, the new hepatitis C drug from Gilead ($GILD) that costs an eye-popping $84,000 for a 12-week course. Although the treatment is a cure for most patients, insurance companies and administrators of government-run health plans continue to struggle with the question of whether they can afford to finance the drug over the long run.

As for the discussion of price at this year's ASCO meeting, many oncologists say they will welcome the guidance from the organization, which is developing an algorithm to rate the cost-effectiveness of cancer drugs. One supporter is Neal Meropol, an oncologist at the University Hospitals Seidman Cancer Center in Cleveland, who is chairing a panel on the value of cancer treatments at the meeting. "The amount of support we need to provide to patients in navigating the financial aspects of their care has increased substantially," he told Bloomberg.

- here's the Bloomberg story