Wednesday, November 14, 2012

Zalcrap contd.

Incredible Prices for Cancer Drugs

An unusually bold stand by doctors at the Memorial Sloan-Kettering Cancer Center in New York has forced a big drug company to reduce the cost of an overpriced drug for treating colorectal cancer that was no better than a cheaper competitor and did almost nothing to extend a patient’s life. It is a heartening sign that alert and aggressive physicians can potentially play a major role in helping to reduce the escalating costs of health care for treatments of marginal value.

The drug is Zaltrap, which was developed by Sanofi, a large French pharmaceutical company, and Regeneron Pharmaceuticals, a small biotechnology company in Tarrytown, N.Y. It was approved by the Food and Drug Administration in August as a second-line treatment for colorectal cancer after initial courses of treatment have stopped working. It is used for treating colorectal cancer that has spread from the colon to other parts of the body and is administered intravenously.

Zaltrap was initially priced at about $11,000 a month, more than double the price of a competing drug, Avastin, made by Genentech, which is itself considered too expensive by many doctors for the minimal medical benefit it delivers. When added to standard cancer treatments, both drugs improve the median survival time of patients by a minuscule 1.4 months.

The doctors at Sloan-Kettering balked at the high price of Zaltrap and decided not to approve the drug for use in the hospital. Three of the doctors then wrote an Op-Ed article in The New York Times explaining their rationale and making a strong case that there is often little relationship between the prices of drugs and the value they provide. Companies often seem to charge what the market will bear for cancer drugs — as much as $35,000 a month and $100,000 a year in various cases.

The president of the American Society of Clinical Oncology recently praised Sloan-Kettering for addressing “the elephant in the room: unsustainable costs in cancer care.” With other doctors expressing support for Sloan-Kettering’s move, Sanofi announced last Thursday that it would effectively cut the price of Zaltrap in half. Sanofi is not changing the official price for Zaltrap but will offer discounts of about 50 percent to the doctors and hospitals who buy the drug and then administer it intravenously to patients.

There are few constraints on escalating cancer drug prices in the current health care market. That will need to change. Sloan-Kettering has shown what the medical profession can do to reduce costs if it has a mind to.

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