(Bloomberg) — Cancer drugs have mostly been immune to the pricing pressure affecting many drugmakers. That’s likely to change, even for new and potentially curative drugs.
Bristol-Myers Squibb CEO Giovanni Caforio recently told reporters that he doesn’t expect to see intense pressure to cut cancer-drug prices. He had better hope not: Bristol-Myers is a leader in immuno-oncology (IO) drugs, which boost the immune system to fight cancer. The drugs can be highly effective, but at a mind-blowing cost. Bristol-Myers sells a combination of two, Opdivo and Yervoy, that costs $256,000 per patient in the U.S.
Cancer drugs do face far less price pressure than medicines that target bigger populations. But the prices of these drugs are growing at an unsustainable clip. The IO market is getting crowded and competitive. Bristol-Myers is already competing for patients with Merck, which has an IO drug similar to Opdivo. Roche just had its own IO drug approved by the FDA, and the market will eventually balloon into a five-way scrap involving Pfizer and AstraZeneca.
Meanwhile, a wave of pricey combos will test the market’s limits. And political pressure on drug pricing generally is growing in the U.S., which shoulders a disproportionate burden of cancer-drug costs. Something’s got to give.
According to IMS Health, a health-care data and technology services company, worldwide spending on cancer drugs reached $107 billion in 2015, an 11.5 percent increase from 2014. Global spending may reach $178 billion by 2020. That growth will be heavily concentrated in the U.S., which accounts for 46 percent of the market for cancer drugs. U.S. cancer-drug spending is up 72 percent in the past five years, driven by a wave of new medicines.
Even more are on the way, and they’re only going to get more expensive.
The U.S. dominates cancer-drug spending mainly because its drug prices are shockingly higher than those in the rest of the world. A large study of cancer-drug prices released earlier this month found the median monthly cost for patent-protected cancer drugs in the U.S. is more than double the cost in any of five comparison countries.
Additionally, U.S. government programs such as Medicare are obligated to pay for essentially all cancer medicines, regardless of their effectiveness or cost. Similar programs in other countries do a cost-benefit analysis before they agree to pay. If a drug’s ability to add quality years to a patient’s life doesn’t justify its price, then they don’t pay for it.
Private insurers can’t or don’t push as aggressively for price discounts on cancer drugs as they do on many other expensive medicines. According to IMS, discounts and rebates managed to shave nearly 4 percent from overall drug-price growth last year in the U.S. In cancer, it was just 1.6 percent. As costs continue to rise, though, cancer drugs will likely finally see more pricing pressure.