Cancer Drugs' High Prices Not Justified by Cost of Development, Study Contends

From - September 12, 2017

Cancer Drugs' High Prices Not Justified by Cost of Development, Study Contends

TUESDAY, Sept. 12, 2017 -- Excusing the sky-high price tags of many new cancer treatments, pharmaceutical companies often blame high research and development (R&D) costs.

But a new analysis, focused on 10 new cancer drugs, finds those costs may have been greatly exaggerated -- and the return on investment for drug companies is lucrative indeed.

The study found that the typical R&D process for a new cancer medication spans about seven years, with an average per-drug cost of between $648 million and $794 million.

Pricey, yes -- but still far below the $2.7 billion-per-drug R&D figure determined by a 2016 Tufts University investigation. It's that number that drug companies have pointed to as their average R&D cost per drug.

And the pay-off, once a new cancer drug reaches the market, can be enormous, the new study found. According to the researchers, after an average of about four years on the U.S. market, the 10 new drugs they studied ended up collectively generating $67 billion in revenue.

That's seven times the total cost of all the drugs' combined R&D.

"These results suggest that pharmaceutical drug development is extremely lucrative, and the current drug prices are not necessarily justified by the R&D spending on these drugs," said study co-author Sham Mailankody. He's assistant attending physician with the myeloma service at Memorial Sloan Kettering Cancer Center in New York City.

Mailankody co-wrote the study with Dr. Vinay Prasad, of Oregon Health and Science University in Portland. The findings were published online Sept. 11 in JAMA Internal Medicine.

At the crux of the issue are skyrocketing U.S. prices for new cancer medications, which often exceed $100,000 a year, sometimes hitting as high as $200,000.

According to Mailankody, there are three common justifications for this "sticker shock": the drug is a novel approach to treating a cancer; it brings improved effectiveness; and it's been produced after some very expensive R&D.

Mailankody said that, in prior investigations, he and Prasad already found that "the cost of anticancer drugs is unrelated to the novelty of mechanism of action or the efficacy of these drugs."

So that leaves the high R&D cost as the sole justification left standing.

To see if that argument held up, the researchers identified 10 drug companies which -- for the first time -- had each gotten a single new cancer drug to market between 2006 and 2015.

The 10 new medicines included: ponatinib (Iclusig); brentuximab vedotin (Adcetris); cabozantinib (Cometriq); ruxolitinib (Jakafi); eculizumab (Soliris); ibrutinib (Imbruvica); enzalutamide (Xtandi); irinotecan liposome (Onivyde); vincristine liposome (Marqibo); and pralatrexate (Folotyn).

Filings lodged with the U.S. Securities and Exchange Commission revealed the total amount each company had laid out for all R&D costs related to cancer drugs -- even when the company successfully brought just one drug to market.

"Our analysis actually accounts for the cost of [all drug] failures" as well, Mailankody explained, rather than just the R&D costs of a single successful drug.

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