Cancer report trumpets progress

The Philadelphia-based American Association for Cancer Research trumpeted progress on the disease in a report released Wednesday, noting that nine new cancer drugs were approved by the Food and Drug Administration in the 12 months ending July 31.

In that period, one new cancer vaccine and one new cancer screening test were also approved. Six other cancer drugs and one imaging agent were deemed worthy of use in patients with forms of cancer beyond the originally approved use.

"Since I started working in the field of oncology about three decades ago, there has been a sea change in our basic understanding of what cancer is," José Baselga, AACR president, said in the report. Baselga is an oncologist at Memorial Sloan Kettering Cancer Center in New York.

Beyond cutting-edge science, the tricky part is the money - the cost of the medicine for payers and the funding for initial research.

The annual AACR report, titled Cancer Progress Report 2015, notes that "the direct medical costs of cancer care" will rise from $125 billion in 2010 to an estimated $156 billion in 2020.

Fellow Memorial Sloan Kettering oncologist Peter Bach is among the doctors who say the U.S. system for pricing medicine is broken. He has tried to help by creating an online tool - www.drugabacus.org - to allow anyone to try to assess the value of a drug.

"I've been in cancer since 1998 and we've never been in such an exciting period of research," Bach said by phone. "But it's also a period of absolute profit maximizing by pharmaceutical companies. We need to fix the problem."

Merck & Co.'s Keytruda and Bristol-Myers Squibb's Opdivo are among the newer medications, so-called immunotherapy drugs that unlock the body's natural defenses against cancer cells. Both companies have big operations in this region. Both drugs are approved for melanoma, a form of skin cancer. Opdivo is also approved for forms of lung cancer.

Each company is seeking much wider FDA approvals to increase the pool of patients for whom it can legally promote the drug. Doctors are allowed to prescribe as they want, though insurers and pharmacy benefit managers have some say and have pushed back on the soaring costs.

Drug prices are negotiable for some powerful companies, but Merck is charging $150,000 for a year's worth of Keytruda, helping to fuel debate about U.S. drug pricing.

Like Bach, Steven D. Pearson president of the Institute for Clinical and Economic Review in Boston, has offered systematic ideas on valuing drugs vs. having drugmakers set the highest price the market will bear. In an online presentation with the media Tuesday, Pearson noted some drugmakers, including Merck and GlaxoSmithKline, had joined the conversation without endorsing anything.

To help researchers on the front end, Baselga argued in the report for increased and stable funding from taxpayers. He wrote that "much of the research that powers progress against cancer is funded by the U.S. federal government," via the National Institutes of Health and its largest subgroup, the National Cancer Institute, and that proper funding of the FDA is necessary to ensure "the delivery of safe and effective treatments" to patients.

Congressional spending cuts in recent years have meant flat NIH funding, and the latest budget is being debated now. Those negotiations include the proposed 21st Century Cures Act, which includes more NIH funding.

Critics of the bill say patient safeguards would be compromised for the sake of quicker approval of drugs and medical devices, which translates to profits for companies.

"The progress against cancer," Baselga wrote, "underscores how unwavering, bipartisan support from Congress and the administration, in the form of sustained increases in funding for the NIH, NCI, and FDA, are vital if we are to continue to make progress for the benefit of families everywhere."

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