Last year, ipilimumab (Yervoy; Bristol-Myers Squibb, New
York, NY) was approved by the Food and Drug Administration (FDA) for the treatment
of metastatic melanoma. The benefit in survival over and above standard
treatment arms was 3.7 months in previously treated patients and 2.1 months in
previously untreated patients. The
cost: $120,000 for 4 doses. As staggering a figure as that is, the drug is
hardly alone in its lofty price. We believe that the immense cost of
contemporary cancer drugs signals even greater costs for future drugs.
The following Table is from their paper as modified. Note
the annual costs. What are not presented are the survival rates, for example
melanoma extends survival 4 months for $120,000. That is $30,000 per month.
Generic drug name
|
Cancer
|
Cumulative drug cost for
1 y ($)
|
Ipilimumab
|
Melanoma
|
120,000
|
Sipuleucel-T
|
Prostate cancer
|
90,000 for 3 doses
|
Bevacizumab
|
Various cancers, including lung
and colon cancer
|
90,000
|
Paclitaxel, protein-bound
|
Breast cancer
|
80,000
|
Lenalidomide
|
Multiple myeloma
|
90,000
|
Bortezomib
|
Multiple myeloma
|
60,000
|
Imatinib mesylate
|
Chronic myeloid leukemia
|
70,000
|
Alemtuzumab
|
Chronic leukemias
|
70,000
|
Ofatumumab
|
Lymphomas and chronic lymphoid
leukemias
|
120,000
|
Brentuximab vedotin
|
Hodgkin lymphoma
|
100,000
|
Dasatinib
|
Chronic myeloid leukemia
|
110,000
|
Now the authors proceed to argue why they are so expensive
and argue as to what can be done to reduce costs. In a sense this is still
health care research financed by the public and not really beneficial drug
disbursement. Almost all of these drugs are at best minimal life prolongers.
Perhaps we are at a very early stage where we use large populations to fund
experimental protocols as well as drugs.
Posts
