The Impact of High Cost Oncology Drugs
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Transcript of The Impact of High Cost Oncology Drugs
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The Impact of High Cost Oncology Drugs
Joshua Jacob
MSci Human Genetics, University College London
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Introduction • Targeted cancer therapies are at a high cost – why?
• How have they affected the political system, health service and public consumer?
• What future strategies should be undertaken to rationalise and reassess these costs?
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How much is spent on oncology drugs?
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Spending in Leading Therapy Areas in the United States, 2011
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Oncology spending by area
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2014 >$25Bn
Oncology spending by area
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Why the high cost?
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Drug / Approval Year
Manufacturer Indication Route Price
Herceptin Approved: 1998
Roche Breast cancer I.V. $70,000 / course
Glivec Approved: 2001
Novartis Chronic myeloid leukemia
Oral $70,000 / course
Yervoy Approved: 2011
Bristol-Myers Squibb
Melanoma I.V. $120,000 / course
Zytiga Approved: 2011
Janssen Prostate cancer Oral $40,000 / course
Stivarga Approved: 2012
Bayer Colorectal Cancer
Oral $9,500 / month
Kadcyla Approved: 2013
Roche Breast Cancer Oral $94,000 / course
Price of FDA-approved Oncology Drugs
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Reasons behind high costs
• Drug development costs
– Preclinical studies
– Phase 1, 2, 3 clinical trials
– Regulatory Approval
• Difficulty in curing cancer with reduced range of treatments
“Cancer treatments are generally representing a monopoly”
Dr S. Vincent Rajkumar (Haematologist), Mayo Clinic
• No generic price check
• Willingness to pay for cancer treatments
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Patent Protection and Expiration
• Patent-protection grants market exclusivity
• Last 10-20 years before expiration
• Patent expiration has a major impact on sales
– Patents on pharmaceuticals with sales of >$260Bn will expire in the next decade – Patent Cliff
– Accounts for 40% becoming available as generic medicines
• Generic medicines can generate huge savings potential
– 2012-2016: €30Bn saved through brand medicines going off-patent in 7 EU Member states, including UK
– Source: European Commission 2012
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100% <25% share in only 6 months
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How does all this affect the political system and
healthcare service?
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• Recent report: Indian Supreme Court rejected a 6-year long plea by Novartis to patent an updated version of its cancer drug, Glivec.
– Generic companies can continue to sell copies of the drug at lower prices
• “Drug companies are motivated by financial gain, in the interest of their shareholders and for investment into research.” – Dr. Angus Patterson, Clinical Oncologist, Antrim Area Hospital,
Northern Ireland
Public Health & Affordability Research and
Innovation
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Drug / Approval Year
Manufacturer Indication Route Price
Herceptin Approved: 1998
Roche Breast cancer I.V. $70,000 / course
Glivec Approved: 2001
Novartis Chronic myeloid leukemia
Oral $70,000 / course
Yervoy Approved: 2011
Bristol-Myers Squibb
Melanoma I.V. $120,000 / course
Zytiga Approved: 2011
Janssen Prostate cancer Oral $40,000 / course
Stivarga Approved: 2012
Bayer Colorectal Cancer
Oral $9,500 / month
Kadcyla Approved: 2013
Roche Breast Cancer Oral $94,000 / course
Price of FDA-approved Oncology Drugs
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• Recent report: Indian Supreme Court rejected a 6-year long plea by Novartis to patent an updated version of its cancer drug, Glivec.
– Generic companies can continue to sell copies of the drug at lower prices
• “Drug companies are motivated by financial gain, in the interest of their shareholders and for investment into research.” – Dr. Angus Patterson, Clinical Oncologist, Antrim Area Hospital,
Northern Ireland
Public Health & Affordability Research and
Innovation
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Strategies and implications for the future • 2014: Launch of an obligatory value-based pricing for new
medicines, replacing the current PPRS (Pharmaceutical Price Regulation Scheme) – Price decisions based on treatment value, innovation, impact on
society and unmet needs – Aided by HTA (Health-technology Assessment)
– Pricing flexibility: price changes based on real-world evidence, e.g. patient-reported outcomes
• Oncology drug development is changing – Personalised treatments
• Need for collaboration/partnerships
• Changes in supply chains and delivery of drugs
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Closing Comments
• Cancer incidence is increasing, with treatments shifting from acute to more chronic care.
• We must find a balance between healthcare affordability and innovatory research
• Generics may be the way forward
Public Health & Affordability
Research and Innovation
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Thank You