Australia is paying for Bristol-Myers Squibb's ($BMY) melanoma drug Yervoy. And Yervoy is expensive. So, Australian officials plan to monitor patients treated with it to see whether the drug lives up to its promise. It's an unusual move--and unprecedented in Australia.
In clinical trials, Yervoy not only delayed the progress of cancer, but actually extended patients' lives. On average, the survival benefit was 3.9 months, but for some patients--one in 10--Yervoy treatment translated into four or more years of life.
But does the experience of clinical trial patients--a small, artificially assembled population--extend to eligible patients at large? That's Australia's question. So, the Pharmaceutical Benefits Advisory Committee, which makes coverage recommendations, is planning its own study. Officials will track details on Yervoy patients--who they are, how long they are treated, which other drugs they are given.
And, most importantly, "What happens to the outcome," says Dr. Suzanne Hill, who chairs the PBAC (as quoted by Four Corners, an Australian Broadcasting Co. program). "Do we get the survival benefit in the community that we saw in the trials?"
Yervoy treatment runs $110,000. It's part of a new generation of very expensive cancer drugs. The mounting price tags have payers and health officials concerned about society's ability to pay--and patients' ability to foot their share of the bill, which can be substantial. At a 20% co-pay, a common share, patients would be on the hook for $22,000 in Yervoy's case (at full retail, which doesn't include payer-negotiated rebates and discounts).
Like its pricey counterparts in other diseases, Yervoy has run into some reimbursement hurdles. It finally won approval from U.K. cost-effectiveness gatekeepers late last year, after Bristol-Myers offered a discount. But Pfizer's ($PFE) Xalkori, an expensive targeted lung cancer drug, which works very well in its small designated patient group, recently got the brush-off from the same cost watchdogs.
- read the ABC story
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