Cancer drugs prices vary up to 388% between high-income countries
pharmafile | December 4, 2015 | News story | Medical Communications, Sales and Marketing | Cancer, Drug pricing, Eli Lilly, Genzyme, Lancet, Novartis, oncology
The price of new cancer drugs varies widely between high-income countries in Europe, Australia, and New Zealand, new research published in The Lancet Oncology has found.
The study is the first cross-country price comparison of cancer drugs for a large number of high-income countries. It reveals that overall the UK and Mediterranean countries such as Greece, Spain, and Portugal pay the lowest average unit manufacturer prices for a group of 31 patented cancer drugs, while Sweden, Switzerland, and Germany pay the highest prices.
The greatest differences in price were noted for Eli Lilly’s Gemzar (gemcitabine) – used in the treatment of various cancers including breast, lung, pancreatic, and ovarian cancer – which costs €209 per vial in New Zealand and just €43 in Australia. Novartis’ Zometa, (zoledronic acid), for the prevention of bone complications in advanced cancer, costs €330 per vial in New Zealand, but just €128 in Greece.
“Public payers in Germany are paying 223% more in terms of official prices for interferon alfa 2b for melanoma and leukaemia treatment than those in Greece,” says lead author Dr Sabine Vogler, from the WHO Collaborating Centre for Pharmaceutical Pricing and Reimbursement Policies in Vienna, Austria. “For gefitinib to treat non-small-lung cancer, the price in Germany is 172% higher than in New Zealand.”
Cancer drug prices have risen sharply in recent years, putting further pressure on healthcare systems feeling the strain of growing and ageing populations. In the European Union, healthcare expenditure on cancer was around €51 billion in 2009, with cancer drugs accounting for almost a third of this expenditure. In Australia meanwhile, spending on cancer drugs rose from Aus$65 million in 1999–2000 to $422 million in 2011–2012.
Vogler and colleagues reviewed official drug price data from the Pharma Price Information (PPI) service of the Austrian Public Health Institute for 16 European countries, and from the pharmaceutical schedules in Australia and New Zealand, to find out what manufacturers charged for a unit (tablet or vial) of 31 originator cancer drugs in June 2013.
Of the 31 drugs, none had a unit price lower than €10. Four drugs (13%) had an average unit manufacturer price between €250 and €500, and two drugs (6%) had an average unit price between €500 and €1000. Seven drugs (23%) had an average unit price in excess of €1000, including Genzyme’s Mozobil (plerixafor) for haematopoietic stem-cell transplantation in patients with lymphoma or multiple myeloma, which cost over €5000 per injection.
The difference in the prices of drugs in the highest and lowest-priced countries ranged from 28% to 50% for a third of the drugs sampled, between 50% and 100% for half of the drugs, and between 100% and 200% for three drugs.
The report’s authors noted, however, that information on real drug prices is scarce, and that the cancer drug prices they surveyed did not include confidential discounts such as those agreed in the managed-access schemes increasingly common in countries such as Australia, Italy, the UK and the Netherlands.
“Some high-income countries have managed to barter the manufacturers down to lower prices, but these agreements, including the agreed prices, are confidential. Although these agreements ensure patient access to new drugs, other countries risk overpaying when setting drug prices through the common practice of external price referencing, or international price comparison, because they can only use the official undiscounted prices as a benchmark. There needs to be far more transparency,” explains Vogler.
She adds: “We hope that our findings will provide concrete evidence for policymakers to take action to address high prices and ensure more transparency in cancer drug pricing so that costs and access to new drugs does not depend on where a patient lives.”
David Watson, director, of pricing and reimbursement at the ABPI adds: “The study is further evidence that newer medicines are at prices which are affordable in the UK, and it acknowledges the difference between the often quoted ‘list price’ and the lower prices actually paid for medicines by the NHS. This suggests that the UK is getting a fair deal with regards to medicines pricing and that the NHS can be assured that it is getting good value for money.
But he adds: “We know patients are still not getting access to some new and innovative medicines. The UK has poor outcomes for cancer care compared to some of these comparable countries. If we really want our hospitals here in the UK to provide world class cancer care, we need to invest and ensure our system can accelerate the use of clinically and cost effective medicines. Government has a key role to play in allowing this to happen.”
Joel Levy
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