GREG'S LEGACY

Specialising in the human experience of Living with prostate cancer – warts and all

The Costs of Cancer Medications

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Drug Expenses

Drug Expenses

Following on from my previous article where I updated the situation with the new prostate cancer drug Abiraterone Zytiga) and its inclusion on the Austarlian PBS scheme. This drug has been approved in Australia but is held up by government bureaucracy  from being available on the PBS list for patients. It just seemed so right that the following article seemed to flow on from where I left off.

Most healthy people never consider drug or treatment costs for a major illness. Nor do they consider who pays for all this stuff if they are unlucky enough to become chronically ill. Complacency among the healthy helps shield them from worry when things are going fine. However if you’re a cancer patient or a chronically Ill patient using one the new miracle drugs, you already know about these things. I write this information in the cause of bringing this to peoples attention, both the healthy and chronically ill.

Recently a group of more than 100 oncologists specializing in chronic myeloid leukemia (CML) co-authored an article in the American Society of Hematology Journal “Blood” questioning the need for and ethics of drug companies charging patients $100,000 or more a year for medications.

 A major sponsor of the article was Dr. Brian Druker, Director of the Knight Cancer Institute at Oregon Health and Science University in Portland, Oregon. Dr. Druker was the main developer of one of the drugs in question, Gleevec. This drug has been very successful for patients with CML for more than 10 years. Although he gets nothing for developing the drug, the drug company that manufactures and sells the drug has systematically increased the cost of Gleevec from about $30,000 a year in 2001 to about $100,000 a year in 2013. The result is billions in profits. You’d think prices would go down after all the startup and research costs were covered. These oncologists hope to open a useful dialog with the drug companies.

So this question should be asked of  pharmaceutical companies….. Is this blatant profiteering??? The answer to this question is not a simple one as the following information has to be considered. First comes the cost of researching the drugs. The average cancer drug costs an estimated $60 to $90 million to research. In the United States, it takes an average of 12 years for an experimental drug to travel from the laboratory to your medicine cabinet. That is, if it makes it. Only 5 in 5,000 drugs may successfully enter preclinical testing and progress to human testing. Then one of these 5 drugs that are tested in people is approved. The chance for a new drug to actually make it to market is approx 1 in 5,000.

On the other hand once a company sells about a billion dollars of a drug, most of the rest is profit. For one such leukemia drug released in 2001, that benchmark was passed in 2003, leaving nearly a decade—and counting—of pure profit for its manufacturer.

The costs of some approved prostate cancer drugs in Australia and the United States of America are as follows and are approximate.

Docetaxel – US $18000 per patient

Cabazitaxel (Jevtana) – US$8000 per vial typically 6 vials used.

Abiraterone acetate (Zytiga) US$3600 per month.

Enzalutamide (Xtandi) formerly MDV3100 Not yet approved in Australia but cost in the USA is US$7,500 dollars per month.

Provenge- Not yet approved in Australia but cost in the USA is US $93000.

I tried to research the personal cost of these drugs to cancer patients by comparing Australian costs with the American system and failed. I apologise in advance to Americans for my complete confusion and possible misunderstanding of their system. The American system is complex and involves different insurance coverage and is dependant on the state you live in. I can say that most insurance coverage for cancer drugs in the USA  include a co-payment scheme where the insurance company may pay 80% and the patient 20% of the cost of drugs. My search also revealed that approx 50 million Americans are not insured and that a huge proportion of bankruptcies in that country are the direct result of medical costs.

I am just so glad and grateful that I am an Australian living in this lucky country where these approved cancer drugs are listed on our PBS. ( pharmaceutical Benefit Scheme) As a result of this, the cost of these drugs to cancer patients in Australia is minimal. In a cancer patients hour of need Australia stands by its citizens.

Health Expenses

Health Expenses

In closing this article it must be remembered that this is a huge issue and one with many moral arguments. These moral arguments are both for and against the cost of these medications versus the possible increase in survival times and quality of life they offer to patients toward the end of their lives. Thought must also be given to patients with other major health disabilities ( eg Cystic Fibrosis) who cannot access costly quality of life drugs because they are not listed on the Australian PBS system and are thus prohibitively expensive for the average patient. 

Lee aka Popeye

Further Reading:

http://www.cbsnews.com/8301-18563_162-57581515/cancer-specialists-slam-high-cost-of-drugs/

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2888017/

http://www.economist.com/node/18743951

http://www.thedailybeast.com/newsweek/2012/08/26/the-cancer-breakthroughs-that-cost-too-much-and-do-too-little.html

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