Spending on cancer drugs has doubled over the past five years, and little wonder: Every new cancer drug brought to market last year cost $100,000 or more, according to a new report. The average cost of a new drug released in 2017 was $150,000, according to the report from The IQVIA Institute for Human Data Science, formerly IMS Health and Quintiles. Those drug costs are expected to double again by 2022, the report finds. That compares to the average $79,000 cost of new cancer drugs that hit the market in 2013. “Global spending on cancer medicines — both for therapeutic and supportive care use — rose to $133 billion globally in 2017, up from $96 billion in 2013,” the report reads. But despite outrage among consumers and a focus on drug costs from the Trump administration, cancer patients with commercial health insurance pay on average of $500 out of pocket a year for these drugs, the report finds. “For retail drugs, the extensive use of coupons helps offset patient out-of-pocket costs,” the report reads. David Mitchell, a cancer patient who founded the group Patients for Affordable Drugs, said if health insurance companies are shouldering these costs, they’re passing them along to customers in the form of higher premiums. Let our news meet your inbox. The news and stories that matters, delivered weekday mornings. “Worse, these drugs are almost always built on science paid for by taxpayers through the NIH (National Institutes of Health). So we wind up paying twice — once to invent the drug and again when it comes to market,” he said. Plus, coupons cannot be used by patients on Medicare, the federal health insurance plan for just about everyone over 65. “So there is no help for patients on that front,” Mitchell said. “Moreover, the savings from coupons outside of Medicare are more than made up for with increased prices that we pay for in our premiums and taxes.” Cancer is the No. 2 cause of death in the U.S. and in most other industrialized countries, after heart disease. But for some states, it’s the No. 1 cause of death. The American Cancer Society predicts that 1.7 million people will be diagnosed with cancer in the U.S. in 2018, and that more than 609,000 will die of it. While cancer rates and rates of death have been steadily dropping, drug spending will go up, the IQVIA report predicts. “The global market for oncology therapeutic medicines will reach as much as $200 billion by 2022, averaging 10 to 13 percent growth over the next five years, with the U.S. market reaching as much as $100 billion by 2022, averaging 12 to 15 percent growth,” it predicts. So the issue of paying for cancer drugs gets emotional. Treating cancer has evolved considerably in recent years. Older chemotherapies were toxic and had hit-and-miss success because they relied on killing rapidly growing cells. That approach could kill tumors, but could also take out healthy tissue in the gut and, most noticeably, made hair fall out. Targeted approaches have helped reduce toxicity and resulted in patients living longer. And targeted immunotherapies, which help the body’s own immune system scour for and destroy cancer cells, have had remarkable results in some people. That number is limited, and the IQVIA report shows that. “Most cancer drugs — including those with high annual costs — are used by relatively few patients, with about 87 percent of drugs being used by fewer than 10,000 patients in 2017,” the report reads. Eight of the new drugs launched in 2017 were pills, including new drugs to treat breast cancer, lung cancer, some types of leukemia and ovarian cancer. Two new therapies approved in 2017 are called chimeric antigen receptor T-cell therapies (CAR-T) and involve removing a patient’s immune cells to genetically re-engineer them. One of the treatments, called tisagenlecleucel, treats a type of acute lymphoblastic leukemia and costs $475,000 and one called axicabtagene ciloleucel treats a precursor of acute lymphoblastic leukemia and costs $373,000. None of the new drugs is a home run. The CAR-T therapies are too new to be able to report long-term rates but for tisagenlecleucel, 76 percent of patients were still alive after a year and for axicabtagene, more than 80 percent of patients were helped to some degree for 15 months.
Soaring drug costs have led to a spike in US spending on cancer medicine, which has doubled since 2013. Photograph: By 2022, US costs are forecast to double yet again, while the global market for cancer therapeutic medicines is expected to reach $200bn.