Abstract

ECONOMICS OF CANCER MEDICINES

Cancer is the most important economic disease facing developed countries. The world wide cost of cancer due to premature death and disability (not including direct medical costs) has been estimated to be $895 billion USD (in 2008 figures). This is not simply about absolute numbers but also the rate of increase of expenditure on cancer. What are the drivers and solutions to the ‘cancer cost curve’ in developed countries? How are we going to afford to deliver high quality and equitable care? The drivers of these costs are multiple – demographic, techno-cultural and macro-economic. Multiple drivers of cost such as over-utilisation, rapid expansion and shortening ‘life cycles’ of cancer technologies (medicines, imaging modalities etc); the lack of suitable clinical research and integrated health economic studies, to name but a few, have converged with more defensive medical practice, a less informed regulatory system, a lack of evidenced based socio-political debate and a declining ethos of fairness for all cancer patients. Urgent solutions to this state of affairs range from the re-engineering of the macro-economic basis of cancer costs, e.g. coverage with evidence development and value-based approaches to ‘bend the cost curve’ and allow cost saving technologies to actually gain traction, greater education of policy-makers, and an informed and transparent regulatory system. A radical shift in cancer group think is also required. Political acceptance that unfairness in access to affordable cancer treatment is unacceptable, as well as a need for the cancer profession and industry to take responsibility and not to accept sub-standard evidence base, an ethos of minimal benefit at whatever cost, and the delivery of fair prices and real value from new technologies.