Are costly cancer therapies actually cost effective?

Written by Ilana Landau, Editor

The results of two landmark studies, presented at the European Society for Medical Oncology Congress 2019 (ESMO; 27 September–1 October, Barcelona, Spain) suggest that the high costs of novel cancer therapies may not match up with the health gains they deliver patients.

Over the last 15 years, many novel, high-cost therapies for solid tumor cancers have been marketed. However, it has been difficult to determine to what extent patients benefit from these therapies such that their high costs are justified. In two, first-of-their-kind studies, researchers have observed that, compared with standard treatments, expensive, innovative cancer treatments may be less cost effective.

Both studies sought to determine to what extent the monthly treatment costs of new solid tumor therapies were correlated with significantly improved health outcomes for patients, such as prolonged survival and improved quality of life.

The first study concerned 36 drugs approved in France between 2004 and 2017. The European Society for Medical Oncology Magnitude of Clinical Benefit Scale (ESMO-MCBS) was employed to evaluate the health outcomes benefits these drugs conferred on patients. 48% of the drugs evaluated were associated with low ESMO-MCBS value scores.

Further, when these drugs were evaluated with the Added Therapeutic Benefit Ranking (ASMR) — a scale employed by French drug regulators to determine the cost effectiveness of therapies — 70% of the drugs correlated with low added value.

Marc Rodwin, study co-author from Suffolk University (MA, USA), commented: “This was the first study in France to correlate price with well recognized independent scales of added value and it showed that, while there was a link between cost and added value, it was weak.”

Similarly, in another study concerning 63 approved drugs in both Europe and the USA during 2009—2017, researchers found no association between the high costs of the drugs and their delivered clinical benefits, as assessed by ESMO-MCBS and American Society of Clinical Oncology Value Framework (ASCO-VF) scores, in any country.

Second study co-author Kerstin Vokinger, a Professor at the University of Zurich (Switzerland), stated: “Drug costs were not associated with clinical benefit score in any of the countries we looked at…It is important that drug pricing is aligned with clinical value and that our limited resources are spent on innovative medicines that offer improved outcomes.”