Anyone who's fought cancer knows that it's not just scary, but pricey, too.
"A lot of my patients cry — they're frustrated," says Dr. Ayalew Tefferi, a hematologist at the Mayo Clinic. "Many of them spend their life savings on cancer drugs and end up being bankrupt."
The average U.S. family makes $52,000 annually. Cancer drugs can easily cost a $120,000 a year. Out-of-pocket expenses for the insured can run $25,000 to $30,000 — more than half of a typical family's income.
"These drug prices are completely unsustainable," Tefferi says. "Pharmaceutical companies are in greed mode, and it's sad. It's what I call completely unregulated."
According to a 2013 study, these steep drug prices cause about 10 to 20 percent of cancer patients to skip or compromise the prescribed treatment. Another study found that the launch price of cancer drugs, adjusted for inflation, increased by an average of $8,500 a year between 1995 and 2013.
To make the point, Tefferi recruited 117 other doctors from across the U.S. who share his concerns. Together, they agreed on seven recommendations to make cancer drugs affordable that they want the federal government to consider. The recommendations are laid out in a commentary Thursday in the journal Mayo Clinic Proceedings.
The proposals include allowing the importation of cancer drugs across the U.S. border. Drugs are cheaper in other countries, like Canada, they argue, so why not let people with cancer bring them in for personal use?
They also favor legislation that would stop drug companies from delaying access to cheaper generic versions of their drugs. Tefferi points to Gleevec, or imatinib generically, as an example. It's used to treat chronic myelogenous leukemia and some other cancers. "That drug should have gone generic three or four years ago," he says. "But Novartis is doing all sorts of maneuvers to prevent it."
The doctors recommend a change that could have an even bigger effect: creating a committee to review newly approved cancer drugs and propose a fair price based on their benefits.
"There are tons of drugs [out there] that are very expensive, but they don't work well," Teferri says. "There needs to be a body that does a critical assessment of a drug's value and helps determine what the price should be based on how much it really helps. It needs to be a true, honest and transparent discussion."
The doctors also argue that Medicare should be allowed to negotiate drug prices.
Unlike private insurance, current law prohibits the government-sponsored insurance program from negotiating the cost of drugs with pharmaceutical companies. That means the government program is overcharged and pays the high prices drug companies typically set.
For its part, PhRMA, the main trade group for drug industry, wrote a response to the doctors' commentary that said lowering drug prices would discourage innovation. The trade group also said that cancer drugs represent only one-fifth of total spending on cancer treatment.
But Leonard Saltz, an oncologist at Memorial Sloan-Kettering Cancer Center in New York, said the doctors' proposals are on target.
"I think they, like me and many others, have a deep concern that this is a serious problem that's interfering with access to care," says Saltz, who co-wrote an influential New York Times editorial on cancer drug prices in 2012 that explained why Sloan-Kettering wasn't using a new, more expensive medicine for colorectal cancer. Saltz didn't take part in the latest commentary.
But can a group of doctors voicing their concerns in a journal article really change anything? "This is going to be a very difficult issue to resolve," Saltz says. "No one effort will resolve it, but any effort to engage more people in the discussion and to raise awareness will be helpful."
Saltz adds, "Congress is the organization that's going to be able to make a difference here."