This post was first published on April 4, 2016. We were amused to read an article in the New England Journal of Medicine on June 9, 2022 titled almost the same: “Your Money or Your Life — The High Cost of Cancer Drugs under Medicare Part D.” In the six years since we first wrote about the unconscionable cost of cancer drugs in the US, the problem has only become worse. Back then we noted that cancer research had produced quite a few interesting compounds. Some of them could extend a desperate patient’s life for months or occasionally even longer. Then we asked the question: “if you needed one of these costly cancer drugs, could you afford it? The prices can be breathtaking.”
A Reader Shared This Story About Costly Cancer Drugs:
In 2016 we received this painful message:
Q. I could only gasp when I saw the Medicare summary after I took Opdivo for metastatic melanoma. For each infusion the charge from the hospital pharmacy was over $13,000, plus $800 for administration.
To make matters worse, it did not work. Now I am scheduled to get Keytruda, if my insurance will cover it.
Opdivo and Keytruda for Metastatic Melanoma:
A. New immunotherapy for cancer is unbelievably expensive. Both nivolumab (Opdivo) and pembrolizumab (Keytruda) are considered important advances in the treatment of metastatic melanoma. FDA has also approved them to treat many other cancers, including certain lung cancers, some lymphomas and colorectal cancers, and esophageal cancer. To learn more, you can read about these medications here, here and here. These are incredibly costly cancer drugs.
The original estimate on both these drugs was that they would cost in the range of $12,500 a month. More than 100 leading oncologists have called such prices unsustainable. (You can listen to an NPR interview with one of them, Ayalew Tefferi, MD, of the Mayo Clinic in Rochester, MN.)
Fast Forward to June 9, 2022:
Dr. Stacie Dusetzina is affiliated with the Department of Health Policy at Vanderbilt University School of Medicine and the Vanderbilt-Ingram Cancer Center.
She notes in the New England Journal of Medicine that:
“Undergoing cancer treatment is physically, emotionally, and financially burdensome. For people whose treatment regimens include orally administered anticancer drugs, the financial burden associated with these medications can be overwhelming.”
The author goes on to describe the cost of a breast cancer drug called Ibrance (palbociclib). This medication:
“…would cost approximately $3,100 out of pocket for the first fill and more than $10,500 for 1 year of use for a Medicare Part D beneficiary who doesn’t qualify for low-income subsidies.”
Dr. Dusetzina details other treatments for costly cancer drugs:
“Because most beneficiaries would reach Medicare’s catastrophic-coverage phase — in which coinsurance is 5% — the first time they fill their prescription, out-of-pocket costs for subsequent fills would range from $600 to $1,000 for the remainder of the year. Assuming beneficiaries filled prescriptions for these drugs every month, they would spend between $10,000 and $15,000 out of pocket for 1 year of treatment with a single drug.”
Keep in mind that these people carry insurance through Medicare! What happens to people without insurance?
What About Uninsured Patients? The List Price of Costly Cancer Drugs!
An article in JAMA (June 7, 2022) describes “Trends in Prescription Drug Launch Prices, 2008-2021.”
They relied upon “…a database with quarterly wholesale acquisition cost (ie, list prices) and estimated net prices after manufacturer discounts for more than 1230 brand-name products.”
Hold onto your hat! Here is what they found for costly cancer drugs:
“…oncology drugs (median, $155, 091 [$109, 832-$233,916] per year).”
Costly Cancer Drugs Are Not the Only Problem:
Pharmaceutical manufacturers have also been charging unbelievable amounts for treating a number of rare diseases. Many of these products are called “orphan drugs.” That is because they fit in a particular FDA category of medicines. Congress passed the Orphan Drug Act in 1983. Under this plan, drug companies would develop medications for which they probably would lose money. The FDA referred to such products as:
“significant drugs of limited commercial value.”
You can read about the history and perversion of the Orphan Drug Act at this link.
The researchers writing in JAMA describe how drug prices have skyrocketed over the last 13 years:
“Median launch prices increased from $2,115 per year ($928-$17, 866) per year in 2008 to $180, 007 ($20, 236-409 732) per year in 2021. The proportion of drugs priced at $150, 000 per year or more was 9% (18/197) in 2008-2013 and 47% (42/89) in 2020-2021.”
What Happens When Drug Companies Kill Their Golden Goose?
There is growing recognition that new drug treatments will drive patients, and probably insurance companies, to the brink of bankruptcy or over it. Although cancer drugs are prominent among therapies that cost more than anyone can really afford, there are other medications that break the bank as well. Medicines that cure hepatitis C have been criticized for their pricing as well. 60 Minutes even did an expose on costly cancer drugs.
Many people think that if they don’t need expensive drugs for cancer, HIV, hepatitis, Alzheimer’s disease or rare conditions such as Gaucher disease (which can cost over $300,000/yr) or Duchenne muscular dystrophy ($750,000 for the first year), this is not their problem.
Au contraire! We all end up paying for costly cancer drugs and other “orphan” medicines. That’s because our premiums for Medicare and private health insurance will keep climbing and climbing. The costs will be spread out to everyone eventually.
Do you think it’s time to allow the federal government to negotiate prices with big drug companies? That is how most other countries control the prices of costly cancer drugs and other new medicines. Congress takes a lot of money from the pharmaceutical industry, though. We doubt that there will be any changes unless we convince our representatives in Congress and the Senate to make some changes in how we manage prices going forward.
Have you been treated with an outrageously expensive medication? Or have you had to forego treatment because you could not afford it? Tell us your story below in the comments.
You may wish to read our article titled:
“Will High Drug Prices Soon Destroy Healthcare?”
We ask the question: What will we do if a drug company actually develops an effective medicine against Alzheimer’s disease? We’re talking about something that would keep people out of nursing homes and allow them to resume a normal life! Given the current trends, the cost could exceed $600 billion annually. That is not sustainable!
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