Facts about the Costs and Benefits of Cancer Treatments

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The National Comprehensive Cancer Network (NCCN) says its new tool will provide a clearer picture of the relative value of medication options, particularly in cases where a very expensive therapy does little to improve survival.

Doctors developing the measures expect them to shift demand away from less effective treatments, influencing the prices drugmakers are able to charge. They say they are responding to the needs of patients who are having to pay much more for their own care, with higher health insurance premiums, co-payments and deductibles, and want to know the value of their treatments.

The NCCN, an alliance of 26 cancer centers, envisions the new tool as a supplement to its widely followed guidelines for oncology care, which set out protocols for treating a range of cancers based on diagnosis, disease stage and other factors, such as age.
Other medical groups are also trying to address the cost issue, but not as directly as the NCCN. The American Society of Clinical Oncology (ASCO) is developing its own tool for valuing treatments, but says that its “net health benefit” scores will not consider costs, although prices will be noted alongside the scores. In June, New York’s Memorial Sloan Kettering Cancer Center launched an interactive calculator, called “DrugAbacus,” that allows users to decide how much one of 54 newer drugs should cost based on factors like side effects and novelty.

The NCCN scale, to be launched in mid-October, will employ “evidence blocks” that assign a score of up to five points for each of five measures – price, effectiveness, safety, quality and consistency of clinical data. Initially, it will evaluate drugs used for multiple myeloma and chronic myeloid leukemia. Similar guidelines are expected for most other types of cancer by the end of 2016.
“A company that has an effective drug that’s appropriately priced should welcome these blocks,” said Dr. Robert Carlson, NCCN’s chief executive. If a drug is overpriced, “that’s very important information for everybody.”
Currently, prescribing patterns can be inconsistent, determined by an individual physician’s understanding of published data about a drug, patient preferences and habit. U.S. oncologists also can make a profit on intravenous drugs administered in their offices – calculated as a percentage of a drug’s cost – creating a possible financial incentive for choosing higher-priced therapies.

http://www.reuters.com/article/2015/08/21/us-usa-healthcare-cancer-idUSKCN0QQ1X820150821