Understanding Medicines in the Marketplace

Understanding Medicines in the Marketplace

03.06.13 | By Jenni Brewer

Last week's op-ed in the Washington Post ("Making cancer drugs less expensive") highlighted some important issues related to progress, cost and value in cancer care. These issues are complex, and I'm hoping to use the Catalyst to continue the dialogue and delve into some of the issues they raise.

Let's start where the authors ended their commentary - on the importance of supporting "true clinical value." I could not agree more, and would argue that new medicines to treat cancer have demonstrated unmatched clinical value. In fact, researchers estimate that new cancer medicines -- each backed by rigorous clinical research prior to FDA approval -- are responsible for 50-60% of increases in cancer survival rates we have seen since 1975. According to the National Cancer Institute cancer death rates are down 20% since their peak in 1991 and they attribute recent gains to "primary prevention, early detection, and treatment." I anticipate that future advances will yield even greater gains, particularly as more advances from fields like personalized medicine start to emerge.

While these gains are substantial, the true clinical value of a new cancer treatment typically will not be fully demonstrated when it is first introduced. That is because the trials conducted to support FDA approval are done in carefully controlled settings and involve sicker patients who have often tried and failed other treatment options. A recent analysis concludes that FDA approval often marks a "starting point" for understanding true clinical value, which more fully emerges as further research is done and use of individual treatments evolves. In addition, individual treatments often build on one another to result is significant gains for patients over time. As stated by Dr. Sidhartha Mukherjee in his best-seller The Emperor of All Maladies, "Incremental advances can add up to transformative changes."

Last year, PhRMA President and CEO John Castellani participated in a major conference that started to tackle the complex challenges of sustaining progress against cancer in an era of cost containment. This event and a report based on it provide in-depth insights from a range of perspectives on value in cancer care, and I encourage you to review the report that came out of this conference. As we look at the cost of cancer care, it is important to do so not only in the context of gains made for patients, but also of overall health care spending. As for any patient with a serious, life-threatening disease, the cost of caring for individuals with cancer can be significant, but new medicines are just one part of this cost. According to recent data from IMS Health, spending on oncologic medicines represented less than 1% of total national health expenditures in 2010.

We will use the Catalyst to continue the dialogue and provide some insights on not only medicines and their cost, but their value in our lives (both health and pocket book). I hope this contributes to the discussion of continued innovation in an era of cost containment.

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