Doctors Speak Out Against 'Unsustainable' Rise In Cancer Drug Prices

Originally published on July 24, 2015 2:59 pm
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According to 118 leading oncologists, there's some good news about cancer drugs. New ones are being developed faster than ever. Here's the bad news. A lot of cancer patients can't afford them. In a commentary published today by the journal of the Mayo Clinic, the oncologists call the steady rise in the price of cancer drugs unsustainable. The lead author of the commentary is Dr. Ayalew Tefferi, and he joins us from the Mayo Clinic in Rochester, Minn. Welcome to the program.


SIEGEL: How fast are cancer drug prices rising?

TEFFERI: Almost in an exponential fashion. The price of cancer drugs are doubling and tripling within a few years rather than decades, and they are going much higher than what's our average household income is.

SIEGEL: So the out-of-pocket costs for cancer drugs for a patient might be what?

TEFFERI: Anywhere between 20 and 30 percent. And take into consideration that if we're talking about these new, exciting cancer drugs that are making a real difference in meaningful health outcome are now averaging on an annual rate of about 120,000 plus. We're talking about more than half of the average household income of the average American.

SIEGEL: You cite figures that some people who should be taking drugs don't do so because they just feel they can't afford it.

TEFFERI: Here is a typical scenario. Cancer is a very scary word, so whenever I tell them that they have some form of cancer, that's a catastrophe. That's devastation. Everybody's shocked. But they don't know about the second shock that's coming, and that is the financial destruction that's coming with it. That comes during the course of treatment. That comes after the patient dies. All of a sudden, they see that their lifelong savings is being given to drug companies.

SIEGEL: Have you had patients who, faced with the cost of cancer drugs and other parts of the therapies, would - have sold off the farm or the house or...



TEFFERI: Many. And most patients don't even tell you. They think they're wasting your time. They think that that's their problem, not your problem. They suffer quietly.

SIEGEL: The numbers are such here that drugs that might keep a cancer patient alive for a few months might wipe out 50 years worth of savings and retirement resources, reserves.

TEFFERI: Absolutely. If I may, there's a lot of very expensive concept drugs that have either no or marginal benefit. But there's a huge marketing effort from drug companies to push for the utilization of this drug even though they know very well that there is really marginal benefit or no benefit. I mean, there are examples over examples over examples. And that's why I say their responsibility does not only lie in the drug companies, but the doctors that prescribe this drug.

SIEGEL: So what's the plan that you and the other oncologists would propose to control the cost of the cancer drugs?

TEFFERI: First of all, we're really not against drug companies. They're very important. This is America. Innovation is important. Research and development is very important. What we are against is greed. That's what is really skyrocketing these prices because the prices are fixed by the drug companies. There is no regulation. And so we're proposing that there needs to be some sort of an all-inclusive body after drug approvals that helps in determining the cost of these drugs depending on their actual value and affordability and what have you.

And we're also promoting possibility of making drugs accessible after the drug companies have recouped most of what they have spent for it and stop intervening with the interaction of generic variance of the drug when it's time instead of just being greedy and trying to get more money out for another five years. It doesn't matter what kind of sophisticated argument anybody makes to justify this very high cost of drug. The fact of the matter remains that the patients are suffering, and it is just not fair.

SIEGEL: Do the drug companies have any case to make that the cost for research and development are very high and there are many drugs that they try to develop that don't succeed and that the market for cancer drugs, even as many as cancer patients as there are, isn't quite the same as the market for an anti-cholesterol drug or Viagra or something like that?

TEFFERI: That's the same old argument. In fact, it's becoming a common-knowledge argument, a somewhat boring argument. That's not the point here. The point is there is a crisis, and let's try to get together and find some solution for this crisis. Let's not ignore it.

SIEGEL: Obviously, it's implicit in the case that you and your fellow oncologists are arguing here that if the drug companies got a lot less money for their cancer drugs in the U.S., that would not stifle creativity and innovation at those companies.

TEFFERI: There's really no evidence to suggest that being fair, asking an appropriate profit, and trying to make it as affordable to the major fraction of the population is going to reduce research and development or innovation. I think that argument doesn't hold water.

SIEGEL: The U.S., unlike other countries with national health services, the government doesn't negotiate to get the cheapest possible price for Medicaid or Medicare. That's been baked into federal law. But half of our insurance is private. Aren't our private insurance companies trying to argue down the drug companies? They would have an incentive to keep their premiums low.

TEFFERI: You are absolutely right. You're absolute right. The main component here is the drug companies that need to really change their practices. But this does not spare others. Everybody's responsible here - the insurance companies, Medicare, the government regulators. They need to start regulating this. The doctors also have responsibility. The patients have responsibility. There is nobody who is doing a critical assessment of value. Everybody's writing up the prescription. And somebody's taking it to the pharmacy, and they're taking the drug without asking questions, is it really helping me, or is it just emptying my pockets?

SIEGEL: What do you hope or expect to come from the commentary that you and your fellow oncologists have written and published?

TEFFERI: To begin with, this interview. I mean, this is the way we make the world be acutely aware of our ongoing crisis. And the second point is our major support for patients. Patients have realized that despite our previous efforts, the issue has not caught fire. It has to catch fire and keep burning until solutions are found.

SIEGEL: Dr. Tefferi, thank you very much for talking with us today.

TEFFERI: Thank you.

SIEGEL: Dr. Ayalew Tefferi is an oncologist at the Mayo Clinic in Rochester, Minn., and the lead author of a commentary by more than 100 oncologists pointing to the crisis in the cost of cancer drugs. Transcript provided by NPR, Copyright NPR.