People: Doctors, surgeons, nurses, and other healthcare professionals who work with cancer patients are highly trained and specialized in their field of study. The high cost of anticancer drugs is linked to numerous factors. It is very expensive to move findings from the bench to the head of the bed and complete all regulatory studies (including phase 1, 2, and 3 clinical trials) for approval. Second, because most cancers are incurable, patients receive treatment with each approved agent (sequentially or in combination), creating a virtual monopoly because the use of one drug does not automatically mean that the others are no longer needed.
Third, even when the monopoly is broken with the arrival of “new and improved versions” of an approved drug, the older (and now generic) drug tends to be considered a poor treatment, thus perpetuating the situation. Fourth, the very nature of cancer and the severity of the diagnosis play a role in that patients and physicians are often willing to pay the high price of treatment, even for marginal improvements in outcomes. Finally, our systems offer an incentive to administer more chemotherapy, and there are legal barriers that prevent agencies such as the FDA from considering economic and cost-effectiveness considerations when approving new drugs. 9 It can be argued that a monopoly as described earlier in this document would be temporary at best because similar drugs of the same class would eventually emerge, offering competition that, in theory, should act as a price check.
However, due to some of the factors described hereinabove, the price check offered by generics in non-malignant diseases21-23 is effectively neutralized in the case of cancer. For example, in non-malignant diseases, a new and improved treatment that simply offers incremental benefits over the established treatment, but costs considerably more than the generic version, will not be able to maintain a high price if the incremental benefits do not provide value to the patient. Patients and doctors will switch to less expensive, but almost as effective treatments. However, in the case of life-threatening cancer, because the choice of the new drug is generally associated with metrics such as “superior responses,” improved progression-free survival, and “longer overall survival,” the implications are compounded and the older drug is quickly seen as poor.
quality. treatment. Examples of this in cancer include thalidomide (Thalomid; Celgene Corp, Summit, NJ) versus the more recent analogue, lenalidomide (Revlimid; Celgene Corp); imatinib mesylate (Gleevec; Novartis Pharmaceuticals Corp, East Hanover, NJ) versus nilotinib (Tasigna; Novartis Pharmaceuticals Corp); doxorinib rubicin (Adriamycin; Bedford Laboratories, Bedford, OH or Rubex; Bristol Myers Squibb, New York, NY) vs. liposomal doxorubicin (Doxil; in the U.S.
U.S., Caelyx; outside the U.S. Janssen Products, a unit of Johnson %26 Johnson and Myocet; Enzon Pharmaceuticals Inc, Piscataway, NJ); and paclitaxel (Taxol; Bristol Myers Squibb Co, New York, NY) versus protein-bound paclitaxel (Abraxane; Celgene Corp). New versions of older anticancer drugs do not become alternatives that generate real competition for price. Instead, these new versions eventually become substitutes for older drugs, maintaining a monopoly.
Cheaper generic versions that survive in non-malignant diseases through a variety of maneuvers become obsolete and obsolete when it comes to cancer. The debate over value-based pricing in the United States (if it reaches a national level) for anticancer drugs is likely to be long and arduous. Phrases like “death panels” and “disconnect” grandma can still be heard echoing in political discourse, and the discussion surrounding the Supreme Court's decision to maintain the individual mandate as part of congressional taxing powers will continue to stir up the debate this election year. Therefore, it is unlikely that a price system such as Germany's will be enacted in the United States.
However, allowing the Centers for Medicare and Medicaid Services to negotiate payments for drugs, devices and interventions has the potential to reduce health spending as it has in other countries. 4.2 An argument against price controls and value-based prices is that they run counter to the free market. principles and pricing based on supply and demand. We have already shown in the first section how cancer care is not representative of a “free market system”, and the traditional checks and balances that make the free market system work so efficiently in all other areas are absent when it comes to most cancer treatments.
Another concern is that pharmaceutical companies may refuse to lower prices and deprive American patients of new and potentially interesting treatments. We believe that this is unlikely. According to the Organization for Economic Cooperation and Development, an organization comprised of high-income developed countries that defines itself as committed to democracy and a market economy, total expenditure on pharmaceuticals and other non-durable goods per capita is the highest in the United States. among member countries, 43 the United States is a large market, if not the largest, and the other nations of the Organization for Economic Cooperation and Development have strong drug price regulations.
We believe that pharmaceutical companies would still introduce these drugs to the United States due to the size of our market and would negotiate a lower price to enter. As incredulous as this may seem, it seems to be happening in the UK. Learn and Bach44 suggest that pharmaceutical companies have received approval for pemetrexed (Alimta; Eli Lilly %26 Co, Indianapolis, IN) in the UK by reducing the price and thus improving the profitability of pemetrexed (Alimta) to become part of the National Institute of Health and Clinical The implied profitability of Excellence and ICER Thresholds for Approval. New drugs aren't the only aspect of cancer care that's getting more expensive.
Costs associated with doctors' salaries, diagnostic tests, radiation therapy and surgery are rising, says Darius Lakdawalla, health economist at the University of Southern California at Los Angeles. Collectively, they continue to account for the bulk of spending on cancer care. Despite their small share of health costs relative to other health services, anticancer drugs have a major impact on the lives of cancer patients. Since the beginning of the “war on cancer” in the 1970s, the five-year survival rate has increased 21 percent for breast cancer, 50 percent for prostate cancer, 36 percent for colon cancer, and 54 percent for lung cancer.
A 50% grant is “even beyond what they can afford,” says Lawrence Shulman, director of the Center for Global Cancer Medicine at the Abramson Cancer Center at the University of Pennsylvania in Philadelphia, which works in the East African country. Total out-of-pocket costs depend on several factors, including insurance coverage, types of cancer and treatment, frequency of treatment, and costs related to the cancer center. And it distorts important public dialogue about the cost of anticancer drugs by making anticancer drugs appear to be more expensive than they are, particularly compared to other health care services. Study Published in the Journal of Oncology Practice Shows Wide Variations in Medicare Reimbursement for Radiation Therapy in Cancer Care.
In health care delivery systems where external payers (private or government) cover the costs of cancer treatment and the insured public has a presumed and possibly legal right to access all approved drugs, the increase in the price of cancer drugs raises at least 3 main problems. We must remember that cancer is an extremely complex set of more than 200 diseases, and the path to new anticancer drugs is paved with potential treatments that fail clinical trials. . .