Paying the price (or not)

As PD-1 inhibitors march toward FDA approval, the excitement is warranted–at last, cancer immunotherapies that seem to work for more than a few percent of patients, and maybe even arrive with biomarkers that can identify those patients who can benefit. But the stories about these new drugs, like this one a week ago in the Wall Street Journal, often carry an uneasy undertone about pricing. While the drug makers very understandably don’t want to talk about pricing, Citigroup suggests that this new crop might come in at around $240,000 a year, according to the WSJ story. Moreover, these drugs are likely to be combined with other therapies for best results. Paul Workman of the UK Institute of Cancer Research commented that “with combinations, pricing could quickly become completely unsustainable.” That could be true not just in the UK but in the US, where patients are often bankrupted by their cancer care. The deep concern among oncologists about this issue is becoming more and more public, one sign being the American Society of Clinical Oncology’s plans to assess drug value on cost as well as benefits and toxicity.

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