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Access to and Cost of Cancer Drugs in a Changing Healthcare Landscape
Innovations in cancer therapy, particularly the development of targeted drugs, hold remarkable potential to transform treatment of the disease. A productive oncology-drug pipeline is turning scientific breakthroughs into treatments for many patients who, until recently, had few options. But this innovation comes at a tremendous cost, and accessing needed drugs is increasingly difficult for many patients. As use of targeted cancer drugs and combination therapy continues to grow, so will concerns about access for patients and for the healthcare system overall. The White House, Congress, Federal agencies, presidential candidates, cancer organizations, and advocates are all calling for solutions that strike a balance between supporting innovation in drug development and the potential financial impact drug therapy has on patients and their families.
In this first workshop in a series, the President’s Cancer Panel will convene leaders and stakeholders across multiple sectors to examine access, cost, innovation, and value in cancer drug therapy. Participants will also identify priority topics of focus for discussion in subsequent workshops. Questions for exploration include the following:
- What are the main barriers preventing cancer patients from accessing needed drugs, and which patients have difficulties accessing drug treatment?
- How should the value of a drug be determined?
- How could oncologists and patients be supported in making value-based treatment decisions?
- What are the drivers of price increases and shortages among generic cancer drugs?
- Could actions be taken to make drug approval processes more efficient, patient-centric, and less costly?
This workshop will be co-chaired by Gary Gilliland, MD, PhD, President and Director, Fred Hutchinson Cancer Research Center. Dr. Gilliland is a national leader in cancer genetics, precision medicine, and drug development. Presentations and moderated discussions among participants will inform the Panel's recommendations in a formal report to the President of the United States after the conclusion of series workshops.
Join us on Twitter by following @PresCancerPanel and by live-tweeting during the workshop using #CancerRxValue.
Meetings of the President’s Cancer Panel are open to the public.
Date
June 10, 2016
Time
9:00 am to 4:00 pm
Location
New York Hilton Midtown
Nassau Suite
1335 Avenue of the Americas
New York, NY 10019
| 8:30 | Registration | |
| 9:00 | Welcome and Introductions | |
| 9:45 | Opening Presentations
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| 10:25 | Break | |
| 10:45 | Brainstorm—Cancer Drug Access and Cost: Effects on Clinical Cancer Care | |
| 11:35 | Public Comment | |
| 11:45 | Lunch | |
| 12:45 | Brainstorm—Beyond Clinical Care: Market, Policy, Health System, and Regulatory Effects on Cancer Drug Access and Cost | |
| 1:30 | Input into Future Workshops: Prioritization of Focus Areas | |
| 2:15 | Break | |
| 2:30 | Input into Future Workshops: Topics and Questions | |
| 3:40 | Public Comment | |
| 3:50 | Wrap-Up and Next Steps | |
| 4:00 | Adjourn | |
Julian Adams, PhD
President
Research and Development
Infinity Pharmaceuticals
Peter Bach, MD
Director
Center for Health Policy and Outcomes
Memorial Sloan Kettering Cancer Center
@peterbachmd
Heather Block
Breast Cancer Patient and Advocate
@H3ath3rBlock
Frank Clyburn, MBA
President
Global Oncology Business Unit
Global Human Health
Merck & Co.
Stacie Dusetzina, PhD
Assistant Professor
Division of Pharmaceutical Outcomes and Policy
UNC Eshelman School of Pharmacy
Assistant Professor
Health Policy and Management
UNC Gillings School of Global Public Health
@DusetzinaS
Ann Geiger, PhD, MPH
Associate Director (Acting)
Healthcare Delivery Research Program
Division of Cancer Control and Population Sciences
National Cancer Institute
@NCI_AMGeiger
Gary Gilliland, MD, PhD
President and Director
Fred Hutchinson Cancer Research Center
Hill Harper, JD
Member
President’s Cancer Panel
Author, Actor, and Philanthropist
@hillharper
Clifford Hudis, MD
Chief
Breast Medicine Service
Memorial Sloan Kettering Cancer Center
Chief Executive Officer (Incoming)
American Society of Clinical Oncology
@CliffordHudis
Ron Kline, MD
Medical Officer
Patient Care Models Group
Centers for Medicare & Medicaid Services
Paul Kluetz, MD
Associate Director of Clinical Science
Office of Hematology and Oncology Products
Center for Drug Evaluation and Research
U.S. Food and Drug Administration
Sharon Levine, MD
Executive Vice President
The Permanente Federation
Director and Senior Advisor for Public Policy, Pharmacy, and Professional Development
The Permanente Medical Group of Northern California
Steve Miller, MD
Senior Vice President
Chief Medical Officer
Express Scripts
Meg Mooney, MD
Chief
Clinical Investigations Branch
Cancer Therapy Evaluation Program
Division of Cancer Treatment and Diagnosis
National Cancer Institute
Jeremy Nobel, MD
Medical Director
Northeast Business
Group on Health
Instructor
Department of Global Health and Social Medicine
Harvard Medical School
Loyce Pace, MPH
Executive Advisor
Programs and Policy
LIVESTRONG Foundation
Barbara Rimer, DrPH
Chair
President’s Cancer Panel
Dean and Alumni Distinguished Professor
UNC Gillings School of Global Public Health
Meredith Rosenthal, PhD
Professor
Health Economics and Policy
Harvard T.H. Chan School of Public Health
Abby Sandler, PhD
Executive Secretary
President's Cancer Panel
Special Assistant to the Director
Rare Tumors Initiative
Center for Cancer Research
National Cancer Institute
Frederic Sax, MD
Senior Vice President
Managing Director
Advisory Services
Quintiles
Andrew Schorr, MS
Founder and President
Patient Power
@andrewschorr
Owen Witte, MD
Member
President’s Cancer Panel
University Professor of Microbiology, Immunology, and Molecular Genetics
Director
Eli and Edythe Broad Center of Regenerative Medicine and Stem Cell Research
University of California, Los Angeles
Precision cancer medicine, which includes molecularly targeted drugs and immunotherapies, holds remarkable potential to transform treatment of the disease with tailored and possibly curative drug regimens. However, these innovations come at substantial cost to patients, their families, and the healthcare system, and accessing recommended drugs is increasingly difficult for many patients. The President’s Cancer Panel has identified rising drug prices and threats to access to cancer drugs as critical problems in cancer care. The Panel will focus on these issues in its 2016-2017 series of meetings, Ensuring Patients’ Access to High-Value Cancer Drugs.
Multiple stakeholders must be engaged in identifying solutions that support affordability and access without sacrificing quality or innovation in drug development or the success of the pharmaceutical industry. The first workshop in this series—held June 10, 2016, in New York City—brought together participants with diverse expertise and perspectives, including oncologists, health economists, patients and patient advocates, pharmaceutical and biotechnology executives, academic institution representatives, and federal agency stakeholders.
Participants discussed challenges related to drug costs and access faced by patients, providers, healthcare systems, and payers, as well as factors that influence drug development and pricing. When faced with high drug costs, cancer patients may forgo, delay, or discontinue their treatments because of financial concerns, or incur severe financial strain during an already distressing time. Financial toxicity is real and results in poorer health outcomes. Patients want information about care costs in order to make informed decisions, but healthcare providers are not always comfortable with or knowledgeable about discussing financial issues. It also is challenging to discern patient out-of-pocket costs due to complex healthcare reimbursement policies. Healthcare payers also struggle to support high-quality patient care while containing costs, a considerable challenge as healthcare becomes increasingly expensive. Drug shortages, particularly of generic drugs, create additional challenges for access and cost.
In planning future workshops in this series, participants asked the Panel to look at a variety of factors that influence drug cost and pricing, such as research and development costs, payment models, reimbursement policies and regulations, organizational treatment guidelines, and other market forces. Consideration should be given to rational drug pricing models that assess the value of a drug for patients, taking into account data on clinical outcomes, health-related quality of life, and cost. Such models could help assess the value of expensive but highly effective drugs compared with less effective options. Deliberations should acknowledge rapidly emerging targeted drugs and immunotherapies for cancer, which provide tremendous hope for improved outcomes, but also are expected to be expensive.
Information about future workshops will be posted to the President’s Cancer Panel website as it becomes available. Workshop findings and recommendations for ensuring patients’ access to high-value cancer drugs will be presented in the Panel’s 2016–2017 Report to the President of the United States.
A detailed meeting summary can be accessed here.