(Bloomberg Business) — As the one-year cost of cancer drugs edges up to $200,000 per patient, a top doctor from Memorial Sloan Kettering Cancer Center used his speech before a massive gathering of colleagues to call for limits on the cost of cancer therapies. “These drugs cost too much,” Dr. Leonard Saltz, a gastrointestinal oncologist, said in an unusual speech at the American Society of Clinical Oncology meeting on Sunday.
“We need to first accept that there has to be some upper limit as to what we as a society are going to be willing to spend on a patient, and we have to be willing to engage in that discussion,” Saltz told Bloomberg in an interview from the meeting in Chicago. “It’s a very uncomfortable discussion. We should be willing to have it. Because we’re not having the conversation, only the people selling the drugs are weighing in on what they should cost.”
Saltz has been among an outspoken group of physicians at Memorial Sloan Kettering that has railed against high-priced cancer drugs. He co-wrote a 2012 op-ed in the New York Times defending the decision to stop prescribing a “phenomenally expensive” new drug. In his latest broadside he lit into the cost of a melanoma drug combination from Bristol-Myers Squibb (NYSE:BMY), just hours after another physician from his hospital presented data showing the combination could delay the progression of advanced melanoma by months.
The cocktail combining two existing Bristol-Myers Squibb drugs, Opdivo and Yervoy, would cost the average patient $295,000 for a little less than a year of therapy, Saltz calculated. If all advanced cancer patients in the U.S. received drugs at that price, he projected, the total cost would reach $174 billion per year. An experimental high-dose regimen of another new drug highlighted in Saltz’s speech could cost patients as much as $1 million a year.
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Saltz based his cost estimates on existing prices for individual drugs sold separately. Bristol-Myers declined to say whether it would offer discounts for the combination when it is approved. “It’s premature to speculate on what the pricing strategy will be,” says Michael Giordano, head of oncology development at Bristol-Myers Squibb. He says the company offers one of the “most robust patient assistance programs” to make sure underinsured cancer patients get access to its drugs.
The cost debate is intensifying as drug companies such as AstraZeneca (NYSE:AZN), Roche, Bristol-Myers Squibb, and Merck (NYSE:MRK) race to develop medications that harness the body’s own immune system to fight various forms of cancer. Two of the first drugs on the market, Opdivo and Merck’s Keytruda, cost about $150,000 per year. Drugmakers are starting to combine the immune-therapy drugs for greater effectiveness, raising the potential prices even more.
Alan Venook, an oncologist at the University of California at San Francisco and the scientific program chair for the American Society of Clinical Oncology this year, says he picked Saltz to discuss cancer costs even before he knew that the melanoma combination would be on the program. The problem of rising cancer drug costs “needed to be front and center,” Venook says, and Saltz “is somebody who will really come out there and put it on the table.”