Cost of cancer drugs out of control

Newer cancer drugs that enlist the body's immune system are improving the odds of survival but competition between their developers is not reining in prices - a year's course of treatment can now cost more than $250,000 (about R3.4-million).

The drugs' success for patients is the result of big bets in cancer therapy made by Bristol-Myers Squibb, Merck and Roche, among others.

The industry's pipeline of cancer drugs expanded by 63% between 2005 and 2015, according to the QuintilesIMS Institute, and a good number are reaching the market.

The global market for cancer immuno-therapies is expected to grow more than fourfold globally to $75.8-billion by 2022 from $16.9-billion in 2015, according to GlobalData.

"For cancer drugs in general ... it is hard for us to drive down costs," said Steve Miller, chief medical officer at Express Scripts Holding, the largest US manager of drug benefit plans.

"You don't want to be told to use the second-best cancer drug for your child."

Lawmakers have talked about solutions ranging from price negotiation to faster approval of new drugs, often invoking increased competition between drugmakers.

"Competition is the key to lowering drug prices," US President Donald Trump said in January.

But that is not happening.

New drugs called "checkpoint inhibitors" release a molecular brake, freeing the immune system to recognise and attack cancer cells.

For cancers such as melanoma, the treatments can mean long-term survival for 20% of patients.

Current checkpoint inhibitors have a list price of about $150,000 a year. One combination for advanced or inoperable melanoma has a cost of $256,000 a year.

Scientific progress and pricing power are driving pharmaceuticals companies to emphasise oncology research.

"Most of the strategy of pharmaceuticals companies assumes unrestrained pricing power," said Peter Bach, director of Memorial Sloan Kettering's Centre for Health Policy Outcomes, in New York.