There is growing concern among oncologists and health experts over the expenses involved in cancer treatment, thanks to the arrival of new drugs, many of which are accessible only to a minority who can afford it.
According to a study published in Mayo Clinic Proceedings last year, the average price of cancer drugs for a year of therapy increased from between $5,000 to $10,000 prior to 2000, to more than $100,000 by 2012. The cost of basic cancer treatment – surgery, chemotherapy and radiation – is relatively reasonable, but they have been on an upward spiral owing to the extensive use of targeted chemotherapy drugs and sophisticated technology.
However, the fact remains that most of these treatments have little benefit.
“Oncologists have come to realise that there is a need for minimum threshold for every drug, and that some new drug that costs $60,000 to $100,000 and extends the survival of a patient by just six weeks is not the miracle drug. This is slowly becoming a movement in the US where doctors decline to prescribe drugs which, they feel, offer only incremental benefits,” said Scott Berry, medical oncologist and programme director of medical oncology training programme, University of Toronto, Canada.
Dr. Berry, who is on a visit to the Regional Cancer Centre, is interested in the bio-ethical issues in the care of patients, end-of-life care as well as funding new and expensive treatments.
In 2011, under the Canadian Agency for Drugs and Technologies in Health (CADTH), an independent, not-for-profit organisation, the Pan-Canadian Oncology Drug Review (PCODR) was set up. This is an evidence-based cancer drug review process, which reviews clinical evidence, cost-effectiveness, and patient perspectives and makes recommendations to Canada’s provincial governments on the rationale of using various cancer drugs,” Dr. Berry said.
PCODR brings together multi stakeholders – oncologists, family physicians, health economists, patient groups and members of the public – for a thorough and objective evaluation of clinical, economic and patient evidence on cancer drugs. Every new cancer drug is reviewed for clinical evidence of benefit and if it provides sufficient value to justify the cost.
“ The recommendations by CADTH thus give power to provincial governments in Canada to negotiate with pharma firms to reduce costs,” Dr. Berry pointed out.