On the October 5 edition of CBS’s 60 Minutes, Memorial Sloan Kettering physicians Peter Bach and Leonard Saltz discussed the unsustainable rise in the cost of cancer drugs with correspondent Lesley Stahl. Dr. Bach, who directs MSK’s Center for Health Policy and Outcomes, and Dr. Saltz, Chief of the Gastrointestinal Service, induced a national debate in 2012 when they published an op-ed in the New York Times detailing MSK’s refusal to include a new colorectal cancer drug on the hospital’s formulary because of its high cost.
The drug, Zaltrap®, proved to be no more effective in large clinical studies than a drug already in use — but it was more than twice the cost.
“A cancer diagnosis is one of the leading causes of personal bankruptcy,” Dr. Saltz said in the 60 Minutes piece. Dr. Bach added that “we need to take into account the financial consequences of the decisions that we make for our patients” as each new cancer drug that comes to market costs more than the last, and the burden of that cost is borne increasingly by patients.
The Leukemia Example
But doctors are voicing concerns for their patients and the “financial toxicity” of some treatments. As 60 Minutes noted, leukemia expert Hagop Kantarjian of MD Anderson Cancer Center in Houston was inspired by MSK’s Zaltrap decision to enlist more than 100 of the world’s leading leukemia specialists to co-sign an opinion article in the journal Blood addressing the high price of drugs that treat the disease.
An example is Gleevec®, which has been a game changer for patients with chronic myeloid leukemia but must be taken indefinitely. The cost of Gleevec has tripled since its approval even though other versions of the drug have been brought to market.Back to top
In effect, experts say, the cost of cancer drugs continues to rise exponentially for blockbusters as well as new compounds that add only incremental benefit to drugs already in use.
When asked where to draw the line between how long a drug extends life and how much it costs, Dr. Saltz responded, “We as a society have been unwilling to discuss this topic and, as a result, the only people who are setting the line are the people who are selling the drugs.”Back to top