• Paying for cancer drugs here and abroad

    From Health Affairs, “Compared To US Practice, Evidence-Based Reviews In Europe Appear To Lead To Lower Prices For Some Drugs“:

    In Europe drug reimbursement decisions often weigh how new drugs perform relative to those already on the market and how cost-effective they are relative to certain metrics. In the United States such comparative-effectiveness and cost-effectiveness evidence is rarely considered. Which approach allows patients greater access to drugs? In 2000–11 forty-one oncology drugs were approved for use in the United States and thirty-one were approved in Europe. We compared patients’ access to the twenty-nine cancer drugs introduced into the health care systems of the United States and four European countries. Relative to the approach used in the US Medicare program in particular, the European evidence-based approach appears to have led to reduced prices for those drugs deemed worthy of approval and reimbursement. The result is improved affordability for payers and increased access for patients to those drugs that were available. The United States lacks a systematic approach to assessing such evidence in the coverage decision-making process, which may prove inadequate for controlling costs, improving outcomes, and reducing inequities in access to care.

    Unfortunately, the paper appears to be gated. But the bottom line is this: It appears that in Europe, the main barriers to access of cancer drugs is market availability and reimbursement, while here in the US under Medicare, the main barrier to access for such drugs is out-of-pocket costs. Let me put that another way. In Europe, cancer drugs that are deemed cost-effective are more affordable, but fewer drugs are available overall. In the United States, on the other hand, more cancer drugs are available and covered by Medicare, but they cost more to everyone.

    There are trade-offs here, as there always are. We value choice, while Europe values cost-effectiveness. That’s fine, I suppose. But one of these systems is much, much more prepared to control costs in the future. Can you guess which that is?


    • I am relatively new to the HEOR (health economics and outcomes research) community and even newer to the Health Policy community however that doesn’t mean my interest isn’t peaked by such topics. Aaron I feel that your question is somewhat sarcastic but the problem is so many people in the US wouldn’t agree with you that the EU system is better (as long as your answer is what I believe it is). People in the US have been brainwashed about choice and getting whatever they want, there is such a sense of entitlement here simply becuase people pay insurance premiums. I don’t know what the system or I should say public opinion is like in the EU because I never spent any time there, but I would love for anyone to provide insight for me? Are people as entitled in the EU as they are here when it comes to health care? Either way, since I’m getting off topic one last thing I’d like to ask is why does the US HEOR community put cancer in a separate bucket when it comes to policy decisions? There are dozens of end of life disease, cancer isn’t the only one, and yet when it comes to policy decisions whether they be cost effectiveness or quality of life cancer always breaks the norms. From a new researcher’s perspective it makes the future that much more grim seeing truckloads of money are being spent in oncology products from the pharmaceutical industry side; cancer seems to be the future of health care, it can’t keep continuing to break the odds of typical policy discussion; if it does I dont see how anyone will be able to afford it. Thanks.