Medicines

New cancer drugs are often not worth the cost


New cancer drugs often add little value for patients compared to standard treatments and are rarely worth the extra cost, according to two studies presented at ESMO Congress 2019.

A trial that looked at new cancer drugs to treat solid tumours approved in France between 2004 to 2017 found that almost half had low added value scores on the ESMO Magnitude of Clinical Benefit Scale (ESMO-MCBS), and over two thirds had low added value on the Added Therapeutic Benefit Ranking (ASMR) scale used by French drug regulators.

“This was the first study in France to correlate price with well recognised independent scales of added value and it showed that, while there was a link between cost and added value, it was weak,” said co-author Dr Marc Rodwin, Law School, Suffolk University, Boston, USA.

“…doctors and patients shouldn’t assume that just because a drug is new, it’s going to be better,” he said.

Another study presented by Professor Kerstin Vokinger, from the University of Zurich, Switzerland, that analysed drugs approved for adult solid tumours in four European countries and the USA from 2009-2017, found no link between drug cost and clinical benefit measured by ESMO-MCBS and the American Society of Clinical Oncology Value Framework (ASCO-VF).

Overall, median cancer drug prices in Europe were less than half US prices, the study found.

“Drug costs were not associated with clinical benefit score in any of the countries we looked at. For example, some of the more expensive drugs for prostate and lung cancer in Switzerland had lower ESMO-MCBS scores, while cheaper drugs had higher scores,” Prof. Vokinger said.

Commenting on the findings, Dr Barbara Kiesewetter from the Medical University of Vienna, Austria, and a member of the ESMO-MCBS Working Group, said the new research underlined the growing importance of the ESMO-MCBS in clinical practice in Europe to assist doctors and patients in discussions and decisions on treatment.

“The ESMO-MCBS is very easy to use and anyone can go online to check the scores of cancer drugs, and understand the factors that are used to grade the clinical benefit of medicines. It’s very important to have this validated score not only for daily decision making but to influence reimbursement decisions and reduce treatment disparities,” she said.

“Cost is one of the main reasons why patients are denied access to the newer anti-cancer drugs, and we can use the ESMO-MCBS to clearly demonstrate which drugs provide greatest benefit for patients. By showing which drugs are most likely to be worth the higher cost, we can hopefully improve access to the drugs with greatest value so that patients receive standardised, optimal therapy wherever they live,” she concluded.

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