New Tool for Cost/Benefit Analysis of Cancer Treatments


    The most influential resource for American oncology treatment guidelines is poised to offer a tool which will provide a cost/benefit analysis of available cancer therapies. The National Comprehensive Cancer Network (NCCN) has announced a new vehicle to help doctors consider the relative value of pharmaceutical options, especially in situations where a very expensive drug will do little to improve survival. The physicians in charge of developing the tool say they are cognizant of the needs of patients facing higher health insurance premiums, co-pays and deductibles. These patients want real answers on the respective values of treatment options.

    NCCN, a cohort of 26 cancer centers, establishes protocols for treating various cancers based on diagnosis, stage of the disease and factors such as age. This tool would be a supplement to its existing guidelines. Reuters reports the group will use “‘evidence blocks’ that assign a score of up to five points for five different measures: price, effectiveness, safety, quality and consistency of clinical data.” The tool will launch in October, analyzing multiple myeloma and chronic myeloid leukemia, and information will be added for other cancers throughout 2016.

    The astronomical cost of many cancer drugs has caused other groups to address the issue, as well. The American Society of Clinical Oncology (ASCO) is developing its own tool for analyzing relative benefits. ASCO’s “net health benefit” scores will not factor in costs directly, but prices will be noted. This past June, New York’s Memorial Sloan Kettering Cancer Center launched its interactive calculator, named “DrugAbacus,” that asks users to weight in on how much one of 54 newer drugs should cost.

    IMS Health reports that spending on cancer drugs worldwide reached $100 billion in 2014, a 25 percent increase over the $75 billion spent just five years earlier. Spending in the United States comprised 42 percent of the total.

    Dr. Robert Carlson, NCCN’s chief executive says, “A company that has an effective drug that’s appropriately priced should welcome these blocks.” If a drug is priced unreasonably, “that’s very important information for everybody.”

    Currently, doctors prescribe a drug based on their understanding of the published data, as well as familiarity and habit. American oncologists also have a financial incentive in many cases. They can make a profit on intravenous drugs given to patients in their offices, which may influence their choice of which drugs to use.

    The NCCN will present an assessment of each medication in a straightforward, tabular form, with five components color coded to display a score of one to five. The information will be available on the NCCN website and in printed literature. Over time, the comparison tool will be included in healthcare technology systems used in hospitals.

    There is concern within the drug industry that the sort of cost/benefit analysis NCCN is producing could pose a threat to drugmakers like Roche Holding AG, Novartis aG and Celgene Corp. Reuters says these companies make billions of dollars yearly on cancer therapies that may produce serious side effects and actually fail to extend patients’ lives.