Cancer treatments are among the highest-priced and generate the most profit for the pharmaceutical industry. However, there is significant public investment in the research phases and the clinical trials of many these drugs. This is one of the main conclusions of the report Cancer drugs; high prices and inequality, which we have published on the It’s not Healthy website and as part of the Nos la Juegan campaign.
The unstoppable rise of oncological drug prices, which has doubled in only ten years, has a direct impact on all health systems, increasing pharmaceutical spending and limiting their access in many countries. In Spain, some of the most commonly used therapies for tumors reach 30,000, 40,000 and up too 100,000 euros per patient per year. One of the most unaffordable for the health system, keeping in mind that the number of diagnosed cases continues to grow, which according to the forecast, will grow from 247,000 in 2015 to 315,000 in 2035, almost a 30 percent increase.
This situation is due to a system of intellectual property that leaves price fixation in the hands of pharmaceutical companies and a regulatory framework that lacks transparency, benefiting the industry at the expense of the public interest. The current patent system seeks to ensure the recovery of the resources invested in research, but in reality we do not know those costs because they are kept secretive and the published data does not take into account the public investment. This lack of transparency results in the industry fixing drug prices arbitrarily, depending on each country’s market capacity. An opacity to which we must add the fact that negotiations with public administrations are subject to confidentiality agreements that prevent them from going public with how much is paid for medicines.
The report highlights that in Spain it is not possible to access price agreements between the Government and the industry for these drugs for hospital use and, since the budgetary burden falls on the autonomous communities, this secrecy leads to price difference among regions and even between hospitals, jeopardizing the finite resources of the health system and forcing the cut of other much-need items, such as hiring medical staff, caring for and attending to patients, or equipment for disease management.
It is a particularly concerning situation due to the new laws being debated in Congress that could block any progress in the transparency of drug prices.
Four Revealing Cases
The study analyzes four concrete cases of some of the key medicines for cancer treatment that generate enormous profits for the companies that commercialize them. All of them stand out for significant public investment in their development phase.
The trastuzmab research, for breast cancer, was largely supported by philanthropists and foundations and nearly 50% of the clinical trials we conducted budgets from universities, research centers or non-profit foundations. Today it is one of the Roche’s flagship products and has generated more than 60 billion in sales since its commercialization. In the cases of alemtuzumab (Sanofi) and bevacizumab (Roche), two of the other drugs studied, the report reveals that 70% and 50% of the clinical trials, respectively, have been financed by universities, research centers or non-profit organizations.
The study also analyzes new immunotherapies, the CAR-T therapies. These are novel treatments that modify the cell so the patient’s own immune system to detect and destroy cancer causing cells. Recently, kymriah® (Novartis) and Yescarta® (Gilead) marketing in the US has been approved with the base price exceeding $467,000 for kymriah® and $373,000 for Yescarta®. Again, much of the research that has led to these therapies comes from public resources—more than $300 million in the USA alone. And more than 60% of the clinical trials have been funded by universities, research centers or non-profit organizations.
The cases of alemtuzumab and bevacizumab also reflect some of the various business strategies the industry utilizes to maximize profits. Alemtuzumab multiplied their price by 15 percent –to 58,000 euros—in one year. The drug, initially intended to treat a type of leukemia, was withdrawn by the company and remarketed under a different name with another purpose: to treat multiple sclerosis, thus entering a new market where medicines are more expensive.
On the other hand, bevacizumab is a drug used for different types of cancer, whose sales, since 2004, reach 61 billion euros. This medicine demonstrated effectiveness in treating blindness. Instead of requesting the inclusion of this disease in the list of indication of the drug, the company Genentech/Roche decided to create a new one from bevacizumab, with similar results, but with another name and a price 100 times greater.
Learn more about the campaign here: noslajuegan.org