The President’s Cancer Panel was established in 1971 by the National Cancer Act (P.L. 92-218) and is charged with monitoring the progress of the National Cancer Program—which includes all public and private activities focused on preventing, detecting, and treating cancers and on cancer survivorship—and identifying barriers to effective implementation. The Panel investigates topics of high importance to the National Cancer Program for which actionable recommendations can be made. Information is collected through workshops and additional research. Findings and recommendations are compiled in reports to the President of the United States.
For its 2016–2017 series of workshops, the Panel examined the drivers and impact of rising cancer drug prices in the United States. The Panel convened three workshops to gather information from many stakeholders in this area, including patients, patient advocates, academic researchers, oncologists, health economists, statisticians, and intellectual property specialists, as well as representatives from federal agencies, insurance companies, and the biopharmaceutical industry.
Cancer drug prices in the United States have risen dramatically in recent years. Most new cancer drugs cost more than $100,000 per patient per year,1,2 and per-patient spending on cancer drugs has increased at a much higher rate than spending on other components of cancer care.3 Some patients may face out-of-pocket costs of nearly $12,000 per year for one drug.4 These trends have been driven largely by the emergence and increased use of molecularly targeted drugs and immunotherapies. Some of these drugs have dramatically improved outcomes for patients, and additional promising therapies are on the horizon. However, some cancer drugs do not provide value commensurate with their prices. Drug prices have become an area of significant concern. A nationally representative survey found that more than 90 percent of Americans say cancer drugs are too expensive,5 and high drug prices have garnered attention from the President,6 Congress,7,8 and medical professional organizations.9,10 There is widespread agreement among these stakeholders that rising drug prices are a burden on cancer patients and are straining health system and societal resources.
The Panel concluded that steps must be taken to ensure that drug prices are aligned with their value and to promote use of high-value drugs. Like the American Society of Clinical Oncology9 and the National Academies of Sciences, Engineering, and Medicine,11 the Panel believes that actions to promote value should be patient-centered and facilitate patients’ access to appropriate treatments. It also is critical to recognize the importance of and maintain support for continued innovation in drug development. In this report, the Panel presents several recommendations for achieving these goals. While this report is presented to the President, it also is for a larger group of stakeholders—both public and private—that comprise the National Cancer Program. All of these stakeholders must work together to achieve the common goal of delivering innovative, high-value drugs to cancer patients at affordable prices.
- Mailankody S, Prasad V. Five years of cancer drug approvals: innovation, efficacy, and costs. JAMA Oncol. 2015;1(4):539-40. Available from: https://www.ncbi.nlm.nih.gov/pubmed/26181265
- Bach PB. Cancer drug costs for a month of treatment at initial Food and Drug Administration approval. New York (NY): Center for Health Policy & Outcomes, Memorial Sloan Kettering Cancer Center; 2017. Available from: https://www.mskcc.org/research-areas/programs-centers/health-policy-outcomes/cost-drugs
- Fitch K, Pelizzari PM, Pyenson B. Cost drivers of cancer care: a retrospective analysis of Medicare and commercially insured population claim data 2004-2014. Milliman (commissioned by the Community Oncology Alliance); 2016 Apr. Available from: http://www.milliman.com/insight/2016/Cost-drivers-of-cancer-care-A-retrospective-analysis-of-Medicare-and-commercially-insured-population-claim-data-2004-2014
- Hoadley J, Cubanski J. It pays to shop: variation in out-of-pocket costs for Medicare Part D enrollees in 2016. Menlo Park (CA): The Henry J. Kaiser Family Foundation; 2015 Dec. Available from: http://files.kff.org/attachment/Issue-Brief-It-Pays-to-Shop-Variation-in-Out-of-Pocket-Costs-for-Medicare-Part-D-Enrollees-in-2016
- American Society of Clinical Oncology. National Cancer Opinion Survey: key findings. Alexandria (VA): ASCO; 2017 Oct 24. Available from: https://www.asco.org/sites/new-www.asco.org/files/content-files/research-and-progress/documents/ASCO-National-Cancer-Opinion-Index-infographic.pdf
- Karlin-Smith S. Trump renews attacks on high drug prices. Politico [Internet]. 2017 Oct 16 [cited 2017 Nov 6]. Available from: https://www.politico.com/story/2017/10/16/trump-attacks-high-drug-prices-243836
- Full committee hearing: the cost of prescription drugs: how the drug delivery system affects what patients pay [Internet]. Washington (DC): U.S. Senate Committee on Health, Education, Labor, and Pensions; 2017 Jun 13 [cited 2017 Nov 6]. Available from: https://www.help.senate.gov/hearings/the-cost-of-prescription-drugs-how-the-drug-delivery-system-affects-what-patients-pay
- Full committee hearing: the cost of prescription drugs: how the drug delivery system affects what patients pay, part II [Internet]. Washington (DC): U.S. Senate Committee on Health, Education, Labor, and Pensions; 2017 Oct 17 [cited 2017 Nov 6]. Available from: https://www.help.senate.gov/hearings/the-cost-of-prescription-drugs-how-the-drug-delivery-system-affects-what-patients-pay-part-ii
- American Society of Clinical Oncology. American Society of Clinical Oncology position statement on addressing the affordability of cancer drugs. Alexandria (VA): ASCO; 2017 Jun 1. Available from: https://www.asco.org/sites/new-www.asco.org/files/content-files/blog-release/documents/2017-ASCO-Position-Statement-Affordability-Cancer-Drugs.pdf
- Society for Gynecologic Oncology. Addressing the high cost of drugs for oncology patients: a national priority. Chicago (IL): SGO. Available from: https://www.sgo.org/public-policy/addressing-the-high-cost-of-drugs-for-oncology-patients
- The National Academies of Sciences, Engineering, and Medicine. Making medicines affordable: a national imperative. Washington (DC): The National Academies Press; 2017 Nov. Available from: https://www.nap.edu/catalog/24946