Oncology drugs are extremely expensive, with some costing over $100,000 per treatment course. This high cost is due to drug development costs, market exclusivity from patents, and companies prioritizing profits. However, these drug prices strain healthcare budgets and reduce access. To address this, governments are implementing value-based drug pricing and health technology assessments. In the future, personalized treatments and collaborations may help control costs while continuing to advance cancer care.

1. The Impact of High Cost
Oncology Drugs
Joshua Jacob
MSci Human Genetics, University College London

2. Introduction
• Targeted cancer therapies are at a high cost – why?
• How have they affected the political system, health service
and public consumer?
• What future strategies should be undertaken to rationalise
and reassess these costs?

3. How much is spent on
oncology drugs?

4. Spending in Leading Therapy Areas in the United States, 2011

5. Oncology spending by area

6. 2014
>$25Bn
Oncology spending by area

7. Why the high cost?

8. Drug /
Approval Year
Manufacturer Indication Route Price
Herceptin
Approved: 1998
Roche Breast cancer I.V. $70,000 / course
Glivec
Approved: 2001
Novartis Chronic myeloid
leukemia
Oral $70,000 / course
Yervoy
Approved: 2011
Bristol-Myers
Squibb
Melanoma I.V. $120,000 / course
Zytiga
Approved: 2011
Janssen Prostate cancer Oral $40,000 / course
Stivarga
Approved: 2012
Bayer Colorectal
Cancer
Oral $9,500 / month
Kadcyla
Approved: 2013
Roche Breast Cancer Oral $94,000 / course
Price of FDA-approved Oncology Drugs

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. 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 will
expire 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

12. 100%  <25% share
in only 6 months

13. How does all this affect
the political system and
healthcare service?

14. • Recent report: Indian Supreme
Court rejected a 6-year long
plea by Novartis to patent an
updated version of its cancer
drug, Glivec.
– Generic companies can continue
to sell copies of the drug at lower prices
• “Drug companies are motivated by financial gain, in the
interest of their shareholders and for investment into
research.”
– Dr. Angus Patterson, Clinical Oncologist, Antrim Area Hospital,
Northern Ireland
Public Health
& Affordability Research and
Innovation

15. Drug /
Approval Year
Manufacturer Indication Route Price
Herceptin
Approved: 1998
Roche Breast cancer I.V. $70,000 / course
Glivec
Approved: 2001
Novartis Chronic myeloid
leukemia
Oral $70,000 / course
Yervoy
Approved: 2011
Bristol-Myers
Squibb
Melanoma I.V. $120,000 / course
Zytiga
Approved: 2011
Janssen Prostate cancer Oral $40,000 / course
Stivarga
Approved: 2012
Bayer Colorectal
Cancer
Oral $9,500 / month
Kadcyla
Approved: 2013
Roche Breast Cancer Oral $94,000 / course
Price of FDA-approved Oncology Drugs

16. • Recent report: Indian Supreme
Court rejected a 6-year long
plea by Novartis to patent an
updated version of its cancer
drug, Glivec.
– Generic companies can continue
to sell copies of the drug at lower prices
• “Drug companies are motivated by financial gain, in the
interest of their shareholders and for investment into
research.”
– Dr. Angus Patterson, Clinical Oncologist, Antrim Area Hospital,
Northern Ireland
Public Health
& Affordability Research and
Innovation

17. Strategies and implications for the future
• 2014: Launch of an obligatory value-based pricing for new
medicines, replacing the current PPRS (Pharmaceutical Price
Regulation Scheme)
– Price decisions based on treatment value, innovation, impact on
society 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

18. Closing Comments
• Cancer incidence is increasing, with treatments shifting from
acute to more chronic care.
• We must find a balance between healthcare affordability and
innovatory research
• Generics may be the way forward
Public Health
& Affordability
Research and
Innovation

19. Thank You