1) France has the highest per capita healthcare expenditures in Europe for cancer, estimated at €14 billion annually, resulting in an estimated €17 billion loss to GDP each year from cancer. 2) While drug costs account for about 20% of total cancer costs, they are rising faster than total costs. Imaging costs are also rising rapidly in the US. There is potential to better manage complications as outpatients to reduce hospitalization costs. 3) New models are needed to make drug development and use more cost-effective, such as value-based pricing where drug price reflects quality-adjusted life year benefit, smaller and more targeted clinical trials, and more efficient healthcare systems and drug development processes.

1. Managing costs in higher-income countries David Cameron University of Edinburgh

2. Economics

3. Is there anything more to be said?

4. France Highest per capita health care expenditure in Europe including €14 billion each year on cancer. Estimated annual GDP loss of €17 billion from cancer. ~ 20% of all cancer spend is on drugs

10. Productivity is falling… Even allowing for inflation, industry is investing twice as much in R&D as it was a decade ago to produce two-fifths of the new medicines…..

12. New models ? Phase I. Many drugs………………………… Phase II. Fewer drugs…………… Phase III. Few drugs Phase I. € Phase II. €€ Phase III. €€€€€€€€€€€€€€€ Market €€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€€ Phase I/II. Some drugs… Phase II/III smaller, less data Phase I/II. € Phase II/III. €€€€ Market €€€€€€€€€€€€€

13. Choice in spending

14. Choice in spending for society

20. Make drug development AND drug use cost-effective