The higher price of new cancer drugs is rarely justified

Alessia De Chiara

Most cancer drugs introduced since 2004 provide low added value compared to previously approved medications, but have much higher prices, according to a French study presented at the congress of the European Society for Medical Oncology (ESMO 2019) currently underway in Barcelona.

«Most of the new cancer drugs had low added value, so doctors and patients shouldn’t assume that just because a drug is new, it’s going to be better» said Marc Rodwin, Suffolk University, Boston (USA), co-author of the study. Researchers calculated the correlation between prices and value of medications for solid tumors registered by the European Medicines Agency (EMA) from 2004 to 2017. They found that 48% of drugs had low added value on the ESMO Magnitude of Clinical Benefit Scale (ESMO-MCBS) and 70% scored equally low on the and Added Therapeutic Benefit Ranking (ASMR). Overall, new drugs were in average 2,500 euro more expensive than their older counterpart, but this price increase price did not correlate with added value.

A second study analysed 63 new drugs for adult solid (46) and hematologic (17) cancers approved by the US Food and Drug Administration from 2009-2017 and approved by the EMA by the end of 2018. Median prices of medications in Europe were 52% lower than those in US. Moreover, clinical benefit, calculated by the American Society of Clinical Oncology Value Framework (ASCO-VF) and the ESMO-MCBS, was not associated with cost, nor with the price differential between two countries. «It is important that drug pricing is aligned with clinical value and that our limited resources are spent on innovative medicines that offer improved outcomes» explained study co-author Kerstin Vokinger, from the University of Zurich (Switzerland).

The Magnitude of Clinical Benefit Scale  can be easily used in clinical practice to help reimbursement decisions as well as decision making, by helping to determine which drugs offer the greatest benefit for patients: «By showing which drugs are most likely to be worth the higher cost, we can hopefully improve access to the drugs with greatest value so that patients receive standardised, optimal therapy wherever they live» said Barbara Kiesewetter, Medical University of Vienna (Austria) and a member of the ESMO-MCBS Working Group.

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