The authors of a new study published in the Lancet Oncology say there is no correlation between the cost of cancer drugs and their clinical benefit. They are calling for the clinical benefit of drugs to be better reflected in pricing.
The team from Switzerland, Spain and Harvard Medical School in the US, identified all new drugs with initial indications for adult cancers that were approved by the US Food and Drug Administration (FDA) between 1 January 2009 and 31 December 2017, and by the European Medicines Agency (EMA) up until 1 September 2019. For drugs indicated for solid tumours, clinical benefit was assessed using the ASCO-Value Framework (ASCO-VF) and the ESMO-Magnitude of Clinical Benefit Scale (ESMO-MCBS).
Sixty-five drugs were studied, of which 47 (72%) were approved for solid tumours and 18 (28%) were approved for haematological malignancies.
Overall, the monthly drug treatment costs in the USA were a median of 2.31 times higher than in European countries.
There were no significant associations between monthly treatment costs for solid tumours and clinical benefit using the ESMO-MCBS (P=0.16 for the USA; P=0.98 for England; P=0.54 for Switzerland; P=0.52 for Germany; and P=0.40 for France). Similarly, ASCO-VF found no significant associations in all studied countries except France (P=0.56 for the USA; P=0.47 for England; P=0.26 for Switzerland; P=0.23 for Germany; and P=0.037 for France).
The authors say the prices of cancer drugs should be better aligned with their clinical importance and drugs with low or uncertain benefit should be prioritised for price negotiations, to improve access to beneficial medicines and enable finite resources to be used for treatments that offer patients improved outcomes and optimal value. They say value frameworks could help identify therapies providing high clinical benefit that should be made rapidly available across countries.