The Impact of High CostOncology DrugsJoshua JacobMSci Human Genetics, University College London
Introduction• Targeted cancer therapies are at a high cost – why?• How have they affected the political system, health ser...
How much is spent ononcology drugs?
Spending in Leading Therapy Areas in the United States, 2011
Oncology spending by area
2014>$25BnOncology spending by area
Why the high cost?
Drug /Approval YearManufacturer Indication Route PriceHerceptinApproved: 1998Roche Breast cancer I.V. $70,000 / courseGliv...
Reasons behind high costs• Drug development costs– Preclinical studies– Phase 1, 2, 3 clinical trials– Regulatory Approval...
Patent Protection and Expiration• Patent-protection grants market exclusivity• Last 10-20 years before expiration• Patent ...
100%  <25% sharein only 6 months
How does all this affectthe political system andhealthcare service?
• Recent report: Indian SupremeCourt rejected a 6-year longplea by Novartis to patent anupdated version of its cancerdrug,...
Drug /Approval YearManufacturer Indication Route PriceHerceptinApproved: 1998Roche Breast cancer I.V. $70,000 / courseGliv...
• Recent report: Indian SupremeCourt rejected a 6-year longplea by Novartis to patent anupdated version of its cancerdrug,...
Strategies and implications for the future• 2014: Launch of an obligatory value-based pricing for newmedicines, replacing ...
Closing Comments• Cancer incidence is increasing, with treatments shifting fromacute to more chronic care.• We must find a...
Thank You
The Impact of High Cost Oncology Drugs
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The Impact of High Cost Oncology Drugs

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The Impact of High Cost Oncology Drugs

  1. 1. The Impact of High CostOncology DrugsJoshua JacobMSci Human Genetics, University College London
  2. 2. Introduction• Targeted cancer therapies are at a high cost – why?• How have they affected the political system, health serviceand public consumer?• What future strategies should be undertaken to rationaliseand reassess these costs?
  3. 3. How much is spent ononcology drugs?
  4. 4. Spending in Leading Therapy Areas in the United States, 2011
  5. 5. Oncology spending by area
  6. 6. 2014>$25BnOncology spending by area
  7. 7. Why the high cost?
  8. 8. Drug /Approval YearManufacturer Indication Route PriceHerceptinApproved: 1998Roche Breast cancer I.V. $70,000 / courseGlivecApproved: 2001Novartis Chronic myeloidleukemiaOral $70,000 / courseYervoyApproved: 2011Bristol-MyersSquibbMelanoma I.V. $120,000 / courseZytigaApproved: 2011Janssen Prostate cancer Oral $40,000 / courseStivargaApproved: 2012Bayer ColorectalCancerOral $9,500 / monthKadcylaApproved: 2013Roche Breast Cancer Oral $94,000 / coursePrice of FDA-approved Oncology Drugs
  9. 9. Reasons behind high costs• Drug development costs– Preclinical studies– Phase 1, 2, 3 clinical trials– Regulatory Approval• Difficulty in curing cancer with reduced range of treatments“Cancer treatments are generally representing a monopoly”Dr S. Vincent Rajkumar (Haematologist), Mayo Clinic• No generic price check• Willingness to pay for cancer treatments
  10. 10. Patent Protection and Expiration• Patent-protection grants market exclusivity• Last 10-20 years before expiration• Patent expiration has a major impact on sales– Patents on pharmaceuticals with sales of >$260Bn willexpire in the next decade – Patent Cliff– Accounts for 40% becoming available as generic medicines• Generic medicines can generate huge savings potential– 2012-2016: €30Bn saved through brand medicines going off-patent in 7 EU Member states, including UK– Source: European Commission 2012
  11. 11. 100%  <25% sharein only 6 months
  12. 12. How does all this affectthe political system andhealthcare service?
  13. 13. • Recent report: Indian SupremeCourt rejected a 6-year longplea by Novartis to patent anupdated version of its cancerdrug, Glivec.– Generic companies can continueto sell copies of the drug at lower prices• “Drug companies are motivated by financial gain, in theinterest of their shareholders and for investment intoresearch.”– Dr. Angus Patterson, Clinical Oncologist, Antrim Area Hospital,Northern IrelandPublic Health& Affordability Research andInnovation
  14. 14. Drug /Approval YearManufacturer Indication Route PriceHerceptinApproved: 1998Roche Breast cancer I.V. $70,000 / courseGlivecApproved: 2001Novartis Chronic myeloidleukemiaOral $70,000 / courseYervoyApproved: 2011Bristol-MyersSquibbMelanoma I.V. $120,000 / courseZytigaApproved: 2011Janssen Prostate cancer Oral $40,000 / courseStivargaApproved: 2012Bayer ColorectalCancerOral $9,500 / monthKadcylaApproved: 2013Roche Breast Cancer Oral $94,000 / coursePrice of FDA-approved Oncology Drugs
  15. 15. • Recent report: Indian SupremeCourt rejected a 6-year longplea by Novartis to patent anupdated version of its cancerdrug, Glivec.– Generic companies can continueto sell copies of the drug at lower prices• “Drug companies are motivated by financial gain, in theinterest of their shareholders and for investment intoresearch.”– Dr. Angus Patterson, Clinical Oncologist, Antrim Area Hospital,Northern IrelandPublic Health& Affordability Research andInnovation
  16. 16. Strategies and implications for the future• 2014: Launch of an obligatory value-based pricing for newmedicines, replacing the current PPRS (Pharmaceutical PriceRegulation Scheme)– Price decisions based on treatment value, innovation, impact onsociety and unmet needs– Aided by HTA (Health-technology Assessment)– Pricing flexibility: price changes based on real-world evidence,e.g. patient-reported outcomes• Oncology drug development is changing– Personalised treatments• Need for collaboration/partnerships• Changes in supply chains and delivery of drugs
  17. 17. Closing Comments• Cancer incidence is increasing, with treatments shifting fromacute to more chronic care.• We must find a balance between healthcare affordability andinnovatory research• Generics may be the way forwardPublic Health& AffordabilityResearch andInnovation
  18. 18. Thank You

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