No real rationale for rising cancer drug prices, JAMA researchers conclude

Cancer drug prices are on the upswing, no question. Drugmakers say it's because their meds are not only costly to develop, but more effective and safe than past treatments. But a recent analysis by National Institutes of Health researchers found that prices aren't exactly linked to drug results. In fact, the study concludes, drugmakers are simply charging "what the market will bear."

Published online in JAMA Oncology, the study looked at 51 cancer drugs the FDA approved between 2009 and 2013, comparing their prices with their trial data. Key questions: How long did the drugs keep cancer from progressing? Did they prolong patients' lives, and if so, by how much?

At more than $168,000 per year, the priciest med--among the 20 most recently approved--was Synribo (omacetaxine), a leukemia drug sold by Teva ($TEVA). A few other meds topped $150,000 per year, including Pfizer's ($PFE) targeted lung cancer med Xalkori (crizotinib), Johnson & Johnson's ($JNJ) blood cancer med Imbruvica (ibrutinib), and Celgene's ($CELG) multiple myeloma treatment Pomalyst (pomalidomide). The drugs on the low end--including Roche ($RHHBY) meds such as Perjeta and Gazyva--came in at $59,000 to $78,000 per year.

Less than half of the 51 drugs--21 to be exact--offered new ways of attacking cancer; the remaining 30 were "next-in-class" meds. There was no real difference in the median cost of treatment between the novel meds ($116,100) and the follow-ups ($119,765), the study states.

Many of the newest meds were approved based on response rate, the researchers found, probably because of the FDA's bid to get potentially lifesaving meds to market faster. These tended to be priciest, too, the researchers found, with median costs per year of treatment higher than those approved on the basis of survival data--almost $138,000 for the response-rate drugs, compared with $112,370 for those OK'd on overall survival numbers and $102,677 for progression-free survival approvals.

"Our results suggest that the price of cancer drugs is independent of novelty," the study states, adding that there was "little difference in price" among drugs approved based on survival data and those approved on response rate.

That was the overall, general picture. When the researchers dug into particular survival benefits--the percentage improvement offered by a particular drug--they found no significant relationship between cost and benefits.

The conclusion? Cancer drug prices are rising faster than the prices of treatments for other diseases, and that's worrisome to patients, doctors and policy researchers, the study authors wrote. And unfortunately, the argument for those rising costs isn't very reasonable, they said. "Our results suggest that current pricing models are not rational but simply reflect what the market will bear," the study concludes.

- see the JAMA Oncology article

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