Drug Costs and Prostate Cancer: Charging a Premium for Minimal Efficacy

The Times has an article highlighting the costs of new drugs for prostate cancer. Mind you, these are drugs that have a very limited ability to extend life in patients with advanced disease.

In the last 15 months, three new drugs that extended the lives of prostate cancer patients in clinical trials have been approved by the Food and Drug Administration and several other promising medicines are in clinical trials.

And:

Men with that late-stage cancer had a median survival of about a year and a half using docetaxel. The new drugs each added two to five months to median survival when tested in clinical trials. Doctors say that men taking more than one of the drugs in succession would be expected to live more than two years. (Medicynical note: The last sentence is completely unproven and highly doubtful if it means to live 2 years beyond the original 18 months achieved by docetaxel alone. One wonders which doctors are saying this?)

And:

Provenge costs $93,000 for a course of treatment, while Zytiga costs about $5,000 a month. Another of the new drugs, Sanofi’s Jevtana, costs about $8,000 every three weeks.

With other pricey drugs on the way, said Joel Sendek, an analyst at Lazard, “We could be talking easily $500,000 per patient or more over the course of therapy, which I don’t think the system can afford, especially since 80 percent of the patients are on Medicare.”

Medicynical Note: New drugs are protected by a government sponsored monopoly (patents), allowing a generation of exclusive use to the developer of the advance.

Health care of course is different from computers or other consumer products. There is limited choice about both the timing, source and type of treatments available, particularly in diseases that have fatal consequences.

As such it’s a wonderful set-up for manufacturers. They have exclusive rights to a product that their customers feel they must have. The customer is buffered from the true cost by his/her insurance coverage. The insurer is under huge pressure from the patient to cover everything that they need and simply passes the costs on to policy holders.

Cost efficacy is not a consideration. Patients believe that they will be the one who will benefit and have excellent results. This is the situation even where 1/2 the patients treated get little or no benefit and the treatment at best provides minimal life extension–as in these drugs. It should be re-emphasized that the judgement that these drugs could provide years of survival is completely untested and likely false.


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