Oncology drug costs continue to rise, and the financial distress patients experience has led many to call for efforts to reduce oncology drug prices. Viable policy interventions will not be free and will involve tradeoffs, according to viewpoint from a team of experts published in JAMA Oncology.1
Scott D. Ramsey, MD, PhD, expressed concern that regulating the price of cancer drugs could reduce patients’ access to some cancer medications. Ramsey is a physician, cancer researcher, and economist in his role as director of the Hutchinson Institute for Cancer Outcomes Research at the Fred Hutchinson Cancer Research Center in Seattle, Washington.
Ramsey and 2 colleagues propose 3 policy interventions: (1) give public and private health insurers the ability to negotiate drug prices with manufacturers, (2) give insurers the ability to withhold a product from formularies if a drug’s price does not represent good value, and (3) provide for greater transparency of cancer drug pricing and better information on treatment choices.
“The current model for cancer drug pricing is not sustainable and harms patients and families as well as our health care system,” the authors said. “Solutions are possible that better balance access, affordability and incentives to innovate, but, by necessity, will create situations where low-value drugs are not available except outside of the insurance system. Whether society will accept that ‘pain’ for the gain of a more equitable and sustainable cancer drug market remains to be seen.”
Ramsey and his colleagues explained that, “Efficient markets where consumers understand the attributes of products they purchase are a prerequisite to success. This principle largely fails in the oncology drug market.”
They suggest regulations that compel insurers to show risk, benefit, coverage, and out-of-pocket cost information on cancer drugs in language that is consistent and clear to patients with cancer. They also suggest considering noncoverage of cancer drugs that offer poor value.
1. Ramsey SD, Lyman GH, Bangs R. Addressing skyrocketing cancer drug prices comes with tradeoffs: pick your poison [published online ahead of print February 11, 2016]. JAMA Oncol. doi:10.1001/jamaoncol.2015.5813.