ROCHESTER, MINN. - A group of 118 of the nation's leading cancer experts have drafted a prescription for reducing the high cost of cancer drugs and voiced support for a patient-based grassroots movement demanding action on the issue. Their recommendations and support are outlined in a commentary, co-authored by the group, in the journal Mayo Clinic Proceedings.
"High cancer drug prices are affecting the care of patients with cancer and our health care system," says lead author Ayalew Tefferi, M.D., a hematologist at Mayo Clinic. "The average gross household income in the U.S. is about $52,000 per year. For an insured patient with cancer who needs a drug that costs $120,000 per year, the out-of-pocket expenses could be as much as $25,000 to $30,000 - more than half their average household income."
The group cites a 2015 study by D.H. Howard and colleagues et al, published in the Journal of Economic Perspectives, which found that cancer drug prices have risen by an average of $8,500 per year over the past 15 years.
"When you consider that cancer will affect 1 in 3 individuals over their lifetime, and [with] recent trends in insurance coverage [that] put a heavy financial burden on patients with out-of-pocket expenses, you quickly see that the situation is not sustainable," Dr. Tefferi, says. "It's time for patients and their physicians to call for change."
The group says these actions would improve the situation and allow market forces to work better.
- Create a post-U.S. Food and Drug Administration drug approval review mechanism to propose a fair price for new treatments that is based on the value to patients and heath care
- Allow Medicare to negotiate drug prices
- Allow the Patient Centered Outcomes Research Institute, created through the Affordable Care Act, to evaluate the benefits of new treatments and similar organizations to include drug prices in their assessments of the treatment value
- Allow importation of cancer drugs across borders for personal use (For example, prices in Canada are about half of prices in the U.S.)
- Pass legislation to prevent drug companies from delaying access to generic drugs (pay for delay)
- Reform the patent system to make it more difficult to prolong product exclusivity unnecessarily (patent "evergreening")
- Encourage organizations that represent cancer specialists and patients (e.g., American Society of Clinical Oncology, American Society of Hematology, American Association for Cancer Research, American Cancer Society, National Comprehensive Cancer Network to consider the overall value of drugs and treatments in formulating treatment guidelines
The group also supports the patient-based, grass-roots movement on change.org that advocates against high cancer drug prices with the goal of drawing the attention of pharmaceutical companies and elected representatives to this issue. The authors write, "with proper support of these grass-roots efforts and proper use of that support downstream, it should be possible to focus the attention of pharmaceutical companies on this problem and to encourage our elected representatives to more effectively advocate for the interests of their most important constituents among the stakeholders in cancer - American cancer patients."
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Co-authors include:
Vincent Rajkumar, M.D., Mayo Clinic, Rochester
Morie Gertz, M.D., Mayo Clinic, Rochester
Robert Kyle, M.D., Mayo Clinic, Rochester
Hagop Kantarjian, M.D., University of Texas MD Anderson Cancer Center, Houston
James Allison, University of Texas MD Anderson Cancer Center, Houston
Robert Bast Jr., University of Texas MD Anderson Cancer Center, Houston
Jorge Cortes, M.D., University of Texas MD Anderson Cancer Center, Houston
Isaiah Fidler, D.V.M., Ph.D., University of Texas MD Anderson Cancer Center, Houston
Emil Freireich, M.D., University of Texas MD Anderson Cancer Center, Houston
Jordan Gutterman, University of Texas MD Anderson Cancer Center, Houston
Waun Ki Hong, University of Texas MD Anderson Cancer Center, Houston
Gabriel Hortobagyi, M.D., University of Texas MD Anderson Cancer Center, Houston
John Mendelsohn, M.D., University of Texas MD Anderson Cancer Center, Houston
Louise Strong, M.D., University of Texas MD Anderson Cancer Center, Houston
Naoto Ueno, M.D., Ph.D., University of Texas MD Anderson Cancer Center, Houston
Charles LeMaistre, M.D., University of Texas MD Anderson Cancer Center, Houston
Lawrence Baker, D.O., University of Michigan, Ann Arbor, Michigan
Theodore Lawrence, M.D., Ph.D., University of Michigan, Ann Arbor
Jan Abkowitz, M.D., University of Washington Medical School, Seattle
Joachim Deeg, M.D., University of Washington Medical School, Seattle
Elihu Estey, M.D., University of Washington Medical School, Seattle
Gary Lyman, M.D., M.P.H., University of Washington Medical School, Seattle
John Adamson, M.D., University of California, San Diego School of Medicine, La Jolla, California
Ranjana Hira Advani, M.D., Stanford University School of Medicine, Stanford, California
Steven Coutre, Stanford University School of Medicine, Stanford
Peter Greenberg, M.D., Stanford University School of Medicine, Stanford
Michael Link, M.D., Stanford University School of Medicine, Stanford
Saul Rosenberg, Stanford University School of Medicine, Stanford
Karen Antman, M.D., Boston University School of Medicine, Boston
John Bennett, M.D., University of Rochester Medical Center, Rochester, New York
Edward Benz Jr., M.D., Dana-Farber Cancer Institute and Harvard Medical School, Boston
George Peter Canellos, M.D., Dana-Farber Cancer Institute and Harvard Medical School, Boston
George Daley, M.D., Ph.D., Dana-Farber Cancer Institute and Harvard Medical School, Boston
Daniel DeAngelo, Dana-Farber Cancer Institute and Harvard Medical School, Boston
Charles Fuchs, M.D., M.P.H., Dana-Farber Cancer Institute and Harvard Medical School, Boston
Robert Handin, M.D., Dana-Farber Cancer Institute and Harvard Medical School, Boston
Philip Kantoff, M.D., Dana-Farber Cancer Institute and Harvard Medical School, Boston
David Steensma, M.D., Dana-Farber Cancer Institute and Harvard Medical School, Boston
Richard Stone, Dana-Farber Cancer Institute and Harvard Medical School, Boston
Eric Winer, M.D., Dana-Farber Cancer Institute and Harvard Medical School, Boston
Nancy Berliner, M.D., Brigham and Women's Hospital, Boston
Robert Handin, M.D., Brigham and Women's Hospital, Boston
Joseph Bertino, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey
Ravi Bhatia, M.D., University of Alabama at Birmingham, Birmingham, Alabama
Smita Bhatia, M.D., University of Alabama at Birmingham, Birmingham
Harry Erba, M.D., Ph.D., University of Alabama at Birmingham, Birmingham
Deepa Bhojwani, M.D., Children's Hospital Los Angeles, Los Angeles
Charles Blanke, M.D., Oregon Health & Science University, Portland, Oregon
Clara Bloomfield, M.D., The Ohio State University Comprehensive Cancer Center, Columbus, Ohio
John Byrd, M.D., The Ohio State University Comprehensive Cancer Center, Columbus
Raphael Pollock, M.D., Ph.D., The Ohio State University Comprehensive Cancer Center, Columbus
Linda Bosserman, M.D.
Stephen Forman, M.D., City of Hope Medical Foundation, Duarte, California
Hal Broxmeyer, Ph.D., Indiana University School of Medicine, Indianapolis
Lawrence Einhorn, M.D., Indiana University School of Medicine, Indianapolis
Fernando Cabanillas, M.D., Auxilio Cancer Center, Hato Rey, Puerto Rico
Bruce Chabner, M.D., Massachusetts General Hospital, Boston
Gerardo Colon-Otero, M.D., Massachusetts General Hospital, Boston
Asher Chanan-Khan, M.D., Mayo Clinic, Jacksonville, Florida
James Foran, Mayo Clinic, Jacksonville, Florida
Bruce Cheson, M.D., Georgetown Lombardi Comprehensive Cancer Center, Washington, D.C.
Bayard Clarkson, M.D., Memorial Sloan Kettering Cancer Center, New York City
Sergio Giralt, Memorial Sloan Kettering Cancer Center, New York City
Clifford Hudis, M.D., Memorial Sloan Kettering Cancer Center, New York City
Ross Levine, M.D., Memorial Sloan Kettering Cancer Center, New York City
Martin Tallman, Memorial Sloan Kettering Cancer Center, New York City
Anas Younes, M.D., Memorial Sloan Kettering Cancer Center, New York City
Andrew D. Zelenetz, Memorial Sloan Kettering Cancer Center, New York City
Susan L. Cohn, M.D., University of Chicago, Chicago
Harvey Golomb, M.D., University of Chicago, Chicago
Samuel Hellman, M.D., University of Chicago, Chicago
Richard A. Larson, M.D., University of Chicago, Chicago
Wendy Stock, M.D., University of Chicago, Chicago
Massimo Cristofanilli, M.D., Sidney Kimmel Cancer Center at Thomas Jefferson University, Philadelphia
Walter Curran Jr., M.D., Winship Cancer Institute of Emory University, Atlanta
Fadlo Khuri, M.D., Winship Cancer Institute of Emory University, Atlanta
Sagar Lonial, M.D., Winship Cancer Institute of Emory University, Atlanta
George Daley, M.D., Ph.D., Boston Children's Hospital, Boston
Joachim Deeg, M.D., Fred Hutchinson Cancer Research Center, Seattle
Gary Lyman, M.D., M.P.H., Fred Hutchinson Cancer Research Center, Seattle
Oliver Press, M.D., Ph.D., Fred Hutchinson Cancer Research Center, Seattle
Jerald Radich, M.D., Fred Hutchinson Cancer Research Center, Seattle
Brenda Sandmaier, Fred Hutchinson Cancer Research Center, Seattle
Rainer Stone, Fred Hutchinson Cancer Research Center, Seattle
Francisco Esteva, M.D., Ph.D., New York University Langone Medical Center, New York City
James George, M.D., University of Oklahoma Health Sciences Center, Oklahoma City
Paulo Marcelo Hoff, M.D., Universidade de Sao Paulo, Sao Paulo
Ronald Hoffman, Icahn School of Medicine at Mount Sinai, New York City
Mary Horowitz, M.D., M.S., Medical College of Wisconsin, Milwaukee
Jean Pierre Issa, M.D., Temple University, Philadelphia
Bruce Evan Johnson, M.D., Lowe Center for Thoracic Oncology, Boston
Kenneth Kaushansky, M.D., Stony Brook University, Stony Brook, New York
David Khayat, M.D., Ph.D., Pitié-Salpêtrière Hospital, Paris
Thomas Kipps, M.D., Ph.D.
Scott Lippman, M.D., University of California, San Diego Moores Cancer Center, La Jolla
Margaret Kripke, Cancer Prevention and Research Institute of Texas, Austin, Texas
Maurie Markman, M.D., Cancer Treatment Centers of America, Eastern Regional Medical Center, Philadelphia
Neal Neropol, M.D., University Hospitals Case Medical Center and Case Western Reserve University, Cleveland
Yoav Messinger, M.D., Children's Hospitals and Clinics of Minnesota
Therese Mulvey, M.D., Southcoast Centers for Cancer Care, Fairhaven, Massachusetts
Susan O'Brien, M.D.
Richard Van Etten, M.D., Ph.D., University of California, Irvine, California
Roman Perez-Soler, Albert Einstein College of Medicine, New York City
Josef Prchal, M.D., University of Utah, Salt Lake City
Kanti Rai, North Shore-LIJ Cancer Institute, New York
Jacob Rowe, Northwestern University Feinberg School of Medicine, Chicago
Hope Rugo, University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, San Francisco
Carolyn Runowicz, M.D., Florida International University Herbert Wertheim College of Medicine, Miami
Alan Saven, M.D., Scripps Clinic Medical Group, La Jolla
Richard Silver, M.D., Scripps Clinic Medical Group, La Jolla
Andrew Schafer, M.D., Weill Cornell Medical College, New York City
Charles Schiffer, Barbara Ann Karmanos Cancer Institute, Detroit
Mikkael Sekeres, M.D., M.S., Cleveland Clinic, Cleveland
Lillian Siu, M.D., Princess Margaret Cancer Centre, University Health Network, Toronto
Marc Stewart, M.D., Seattle Cancer Care Alliance, Seattle
Michael Thompson, M.D., Ph.D., Aurora Research Institute, Aurora Health Care, Milwaukee
Julie Vose, M.D., M.B.A., University of Nebraska Medical Center, Omaha, Nebraska
Peter Wiernik, M.D., Cancer Research Foundation, New York City
About Mayo Clinic Proceedings
Mayo Clinic Proceedings is a monthly peer-reviewed medical journal that publishes original articles and reviews dealing with clinical and laboratory medicine, clinical research, basic science research and clinical epidemiology. Proceedings is sponsored by the Mayo Foundation for Medical Education and Research as part of its commitment to physician education. It publishes submissions from authors worldwide. The journal has been published for more than 80 years and has a circulation of 130,000. Articles are available at mayoclinicproceedings.org.
About Mayo Clinic
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