Flush with success in negotiating discounts for hepatitis C drugs, payers are promising to strong-arm drugmakers in other treatment classes, too--cholesterol and cancer, for instance. They'll have more than one oncologist on their sides: A top doctor at the MD Anderson Cancer Center, fed up with cancer drug prices, plans a social media protest.
|Dr. Hagop Katarjian|
Dr. Hagop Kantarjian, who chairs the cancer center's leukemia department, has some experience with fighting pharma, the Houston Chronicle reports. He rounded up 100 doctors to co-sign a commentary in the journal Blood, advocating lower drug prices. He's racked up bylines on op-eds in a variety of news outlets and medical journals.
But that's not working, so he's going to enlist patients. Kantarjian tells the Chronicle that he wants to collect stories and signatures from 1 million leukemia patients, as part of a social media campaign-cum-lobbying effort. Ultimately, he wants Congress to allow the government to negotiate pricing.
There's no denying the rise in oncology drug prices, and with a new round of cancer immunotherapies coming to market, prices aren't likely to drop anytime soon. Bristol-Myers Squibb ($BMY) put a $150,000 price on its new PD-1 therapy, Opdivo, for instance, with Merck's ($MRK) rival Keytruda about the same. Then there are the meds in the $140,000 neighborhood: Bristol-Myers' Sprycel and Erbitux, and Celgene's ($CELG) Pomalyst and Revlimid. All are among the most expensive drugs in the world.
Oncology meds targeted at very small patient populations can be even more expensive; think Pfizer's ($PFE) Xalkori for a rare form of lung cancer, now priced at about $185,000, or Blincyto, Amgen's ($AMGN) targeted leukemia med, at $178,000.
Besides some Part D rebates mandated by the Affordable Care Act, Medicare has no pricing power over drugmakers. Companies set their prices. Lawmakers have tried to give Medicare officials the power to wheel-and-deal with pharma, but those efforts have failed. President Barack Obama proposed the idea once again as part of his latest budget, but with a Republican-controlled Congress, that's a non-starter.
So, private concerns have been leading the charge. Including doctors. Memorial Sloan Kettering Cancer Center in New York nixed Sanofi's ($SNY) colon cancer drug Zaltrap after doctors deemed it too expensive for the benefits it offered--and those doctors wrote a New York Times op-ed about their move. One of those docs, Peter Bach, has been vocal on the subject ever since. The American Society for Clinical Oncology says it's planning a cost-benefits scorecard to help docs navigate pricey meds.
Meanwhile, pharmacy benefits managers CVS Health and Express Scripts, along with a list of insurers and other PBMs, cut formulary deals with Gilead Sciences ($GILD) and AbbVie ($ABBV) in hepatitis C. Express Scripts has said its discounts will allow all its patients access to AbbVie's newly approved cocktail. Next in line may be the forthcoming PCSK9 cholesterol meds--but cancer is also on the target list.
Can Kantarjian's grassroots effort sway opinion enough to trigger bigger changes? Congress does tend to listen to squeaky wheels, if they squeak loudly enough. But Congress listens to money more, and Big BioPharma fields teams of expensive lobbyists--and uses its deep pockets for campaign contributions. The MD Anderson doc might have better luck with payers.
- read the Chronicle story (sub. req.)
Special Reports: Top 10 best-selling cancer drugs of 2013 | Top 10 most expensive drugs of 2013