This year’s meeting of the American Society of Clinical Oncology was a showcase for amazing technological advances in the fight against cancer. Notably, presentations on immunotherapy and specialty drug combinations illustrated a new level of sophistication in oncology care. It’s enough to make physicians and patients hopeful — but managed care payers had to be watching with just a bit of trepidation.
Most major presentations at ASCO (table, page 8) focused on targeted vehicles for stopping the spread of metastatic cancers. GlaxoSmith-Kline (GSK) presented data on two “nibs,” dabrafenib and trametinib, that improved progression-free survival (PFS) in patients with metastatic melanoma. Roche validated the hype about T-DM1, touting a study in women with metastatic breast cancer that showed an antibody-drug conjugate really can work. And Bristol-Myers Squibb showed off early-stage findings of a promising immunotherapy that reduced tumor size in previously treated patients with metastatic melanoma, non-small cell lung cancer, and renal cell carcinoma.
Nobody’s pretending that any of this will come cheap — or that payers won’t balk.
“Reimbursement challenges will remain unless the drug companies dramatically lower the cost of their products,” says Harish Dave, MD, MBA, vice president and medical head of oncology and hematology at Quintiles. Dave is responsible for medical oversight of clinical trials conducted by Quintiles. “This has the potential for getting worse, not better, because at ASCO we saw more discussion of combinations of novel targeted agents.
“As single agents, these are very expensive. Now, do you want to put two really expensive drugs together? Yes — it improves your patient’s overall survival [OS] or response rate. But does it make enough of a difference to justify the expenditure? That’s an open question.”