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May 30, 2017

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Specialists begin to recognize weight of cost on cancer drugs

In the past, money was no object when cancer specialists considered which drugs would provide the best treatment for their patients.

But some top oncologists are rethinking that stance, given the soaring costs of new cancer medicines, reduced reimbursement by insurance plans and fresh research that has identified cases where cheaper generic drugs can work just as well — or better — than expensive brand-name medications.

"Doctors are starting to realize that cost actually is important, especially when high quality can be obtained at a lower cost," said Dr. Otis Brawley, chief medical officer of the American Cancer Society. "I think that's a transformation in medicine. I think that's a good thing."

U.S. spending on oncology drugs and their administration is expected to rise more than 20 percent annually for the next few years, reaching US$173 billion by 2020, according to Express Scripts, which manages prescription drug benefits for employers and other clients.

As scientists unravel the biological underpinnings of cancer cells, new targeted therapies are being developed, but the process is expensive. Avastin, a drug designed to cut off a tumor's blood supply, can cost US$8,000 a month, while a course of treatment with Provenge, a therapeutic vaccine for prostate cancer, is priced at US$93,000.

Researchers are also looking at whether it makes sense to combine targeted cancer therapies — potentially pushing costs well over US$100,000 a year.

Drugmakers maintain that their products, despite high price tags, can save costs by reducing the need for supportive medications or even keeping patients out of the hospital.

"The oncology cost curve is unsustainable," said Rhonda Greenapple, chief executive of Reimbursement Intelligence, a consulting firm specializing in medical reimbursement. "Affordability is more of an issue in therapy selection."

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