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On Cancer: The New York Times Commends Memorial Sloan Kettering’s Stance on a Costly Cancer Drug

By Julie Grisham, MS, Science Writer/Editor  |  Friday, November 16, 2012

In an editorial on November 13, the New York Times commended Memorial Sloan Kettering Cancer Center for taking a leadership position on drug pricing.

By refusing to approve the use of a new colorectal cancer drug at the hospital because of the drug’s high cost and lack of apparent superiority over similar therapies, the editorial indicates, the institution has taken an “unusually bold stand.”

Memorial Sloan Kettering had signaled its decision through a New York Times op-ed article in October. The drug, called Zaltrap®, “has proved to be no better than a similar medication we already have for advanced colorectal cancer,” wrote Peter B. Bach, Director of the Center for Health Policy and Outcomes; Leonard B. Saltz, Chief of the Gastrointestinal Service; and Robert E. Wittes, Physician-in-Chief.

The companies that market the drug subsequently announced that they would effectively reduce the drug price by 50 percent by providing a discount to physicians and hospitals.

Pricing Questions Remain

Although they welcome the drug company’s decision to act, Dr. Saltz and the other physicians continue to question whether the price reduction will actually translate into a drop in Medicare reimbursements or copayments for patients — both of which are tied to the wholesale cost of the drug.

“Another problem with offering a discount without changing the official price of the drug is that this could inadvertently create a financial inducement for providers to choose that drug,” Dr. Saltz explains. “If the providers are getting a 50 percent discount but are still being reimbursed at the full price, prescribing Zaltrap could result in significant profits.”

Zaltrap appears to offer the same survival benefit as an older drug, Avastin®, which works in a similar way, but Zaltrap costs more than twice as much. Neither drug is used alone, and both drugs show modest activity when added to chemotherapy.

Behind the Decision

In making their decision, the physicians indicated that not just the benefits that treatments may deliver but the “financial strains they may cause” need to be taken into consideration in each case.

“Ignoring the cost of care … is no longer tenable,” they wrote in the op-ed. “Soaring spending has presented the medical community with a new obligation.”

Many other cancer experts voiced their agreement. Responding in a letter to the editor, Sandra M. Swain, President of the American Society of Clinical Oncology, praised Memorial Sloan Kettering’s decision for reflecting “a much-needed willingness to address the elephant in the room: unsustainable costs in cancer care.”

“It is a heartening sign that alert and aggressive physicians can potentially play a major role in helping to reduce the escalating costs of health care for treatments of marginal value,” the Times concurred in its November 13 editorial. “Sloan Kettering has shown what the medical profession can do to reduce costs if it has a mind to.”

Comments

I agree with decision. This sends a clear message to drug companies. Even by offering to cut price by 50%, they are still making a large profit. Taking advantage of very ill patients should be a crime.

the cost of co payments and drugs are very high my husband is taking Avastin and if the new drip is the same and cannot make a difference why change

Drug companies are making outrageous profits, and Americans are footing the bill for the lower prices drug companies are forced to accept for for their products in countries with universal health care and drug coverage. I am forced to come in to MSKCC 3x/week for an infusion of an antifungal drug. The charge (paid by Medicare and my supplemental insurance) is over $3000/week. There IS an oral alternative, and taking it would allow me to lead a more normal existence. However, it is a Tier 5 drug, and the manufacturer, Pfizer, doubled the price in August from (full price) $75/day (so a not-in-donut-hole co-pay of $25/day) to $150/day ($50/day co-pay). As I have been doing the 3x/week infusions for 17 weeks now, I have saved a huge amount of money, Medicare/co-insurance have paid through the nose, and my life has been grossly affected by being tied to the infusion schedule - and of course Pfizer made $0. I'm fortunate that there IS an alternative, and the colorectal cancer patients are also fortunate in that they and their families don't have to feel pressured to sacrifice all to pay for a drug that gives no demonstrable advantage.

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