The true cost of cancer drugs is 30% less than a decade ago, once longevity and quality of life are considered, according to a Cornell University researchers based on a study, A Quality-Adjusted Price Index for Colorectal Cancer Drugs, released by the National Bureau of Economic Research (NBER).
The study draws on the experiences of thousands colon cancer patients and treatment decisions by oncologists nationwide, and sheds new light on old assumptions about how to evaluate whether new, costly drugs are “worth” it.
Cornell's researchers analyzed the real-world treatment data from IntrinsiQ, collected through IntelliDose clinical software that oncologists use to determine proper chemotherapy dosing. The data digs deeper than a drug's market share to reveal how it's used, at what stage and whether patients receive the full course of treatment—a key sign of efficacy.
"New drugs, like Avastin and Erbitux, are boosting survival rates nearly 100% from a decade ago—along with a dramatic drop in complications. Patients taking these new drugs are living longer, and significantly improving their quality of life," said Jeff Forringer, president of IntrinsiQ, whose data on the drugs patients receive, and in what combination, were a key component of the study's findings.
Today's leading drugs for colorectal cancer typically are used in new and constantly evolving combinations, which increases the efficacy of treatments and the options available to more patients.
Patients treated with one popular combination report a mean survival of 23.2 months, compared with the mean survival rate of 12.5 months when patients received just one of the drugs, which was the standard of care in 1996. The early treatments were effective for just a small percentage of the patient population. (One of the combinations studied by the Cornell team is bevacizumab (Avastin) + oxaliplatin (Eloxatin) + 5-FU/leucovorin.)
Today's most commonly prescribed 24-week course of treatment costs an average of $36,000, a dramatic increase over the price of a decade ago. Yet the Cornell study reveals that adjusting cost for quality—accounting for the far greater efficacy of today's treatments—prices actually have declined.
The Cornell study estimates the financial value physicians place on eight different attributes of a chemotherapy drug, such as the average number of months patients live if they are taking the drug, or the percentage of patients that experience a severe side effect. Researchers then create a price index by applying these physician value assessments to changes in drug attributes between 1993 and 2005. Accounting for the changing quality of drugs over this time period and the value physicians assign to the attributes, prices have declined by 30%.