What happens when there is promising technology for severe illness that is unaffordable? I’m guessing we’ll find out if the results of the Cleopatra study are applied to clinical practice.
The study noted:
Final results from the CLEOPATRA study show that the combination of 2 targeted agents, trastuzumab (Herceptin, Roche/Genentech) and pertuzumab (Perjeta, Roche/Genentech), significantly prolonged survival in HER2-positive metastatic breast cancer, compared with trastuzumab alone. The targeted agents were added to chemotherapy with docetaxel.
Patients treated with the combination plus chemotherapy lived 15.7 months longer than those who received trastuzumab and chemotherapy (median overall survival, 56.5 vs. 40.8 months; hazard ratio [HR], 0.68; P = .0002).
An added concern is the high cost of dual HER2 inhibition at a time when oncologists are under pressure to contain costs. According to the New York Times, Genentech is putting the wholesale cost of pertuzumab at $5,900/month, which added to the typical $4,500/month costs of trastuzumab, would drive the cost of 18 months of treatment to $187,000.
And this pricing does not include physician fees, imaging expenses, the cost of the additional chemotherapy (taxanes), laboratory and so on.
Medicynical Note: The pricing for the two HER 2 blockers used in the Cleopatra study is three time the median income of families in the U.S. Adding insult to injury, after this huge expenditure the patient is not cured.
The question is who will be able to pay for these drugs? How will such care be funded by insurers? And shouldn’t we be able to develop advanced approaches at more reasonable costs?
As it is the U.S. pays more for everything in healthcare than other places in the world. We are literally bankrupting ourselves individually and collectively. There’s something terribly wrong in a health care “system” whose primary goal is revenue generation.
I was diagnosed with a Her2+ cancer almost 9 years ago. At the time I refused all adjuvant therapy as the heart toxicity, when figured into the cost benefit ratio was almost as much as the benefit of the drug. This given the history of heart issues in the family. It would be interesting to know the health history of those who benefited by 15 months. I can almost guarantee that the test subjects were the healthiest of this particular population and those that weren’t were disqualified from the studies.