title: High cancer drug prices in the United States: reasons and proposed solutions.
abstract: The increase in cancer drug prices in the last 15 years has many contributing factors and is harming our patients and our health care system. It represents to many cancer experts a crossing of a moral line between reasonable profits and profiteering, in a situation involving a human catastrophe: patients who have developed cancer, and who may die because they cannot afford the treatment. With typical out-of-pocket expenses of 20% to 30%, the financial burden of cancer treatment would be $20,000 to 30,000 a year, nearly half of the average annual household income in the United States. Many patients (estimated 10% to 20%) may decide not to take the treatment or may compromise significantly on the treatment plan. This difficult situation poses three relevant questions: (1) Are cancer drug prices too high? (2) Are they hurting patients and our health care system? and (3) Can we do something about it? The answer to each is affirmative. It is also our obligation as cancer doctors to keep patients from "harm and injustice." If high prices make drugs unaffordable and inaccessible, thus causing harm, then we should voice our concerns and advocate for solutions.
authors.affiliation: The University of Texas MD Anderson Cancer Center, Houston, TX; Dana-Farber Cancer Institute-Harvard Medical School, Boston; Edmond J. Safra Center for Ethics, Harvard University, Cambridge, MA; Medecins Sans Frontieres/Doctors Without Borders, New York, NY; and The University of Sydney, Sydney Australia hkantarjian@mdanderson.org.
authors.forename: Hagop
authors.initials: H
authors.lastname: Kantarjian
authors.affiliation: The University of Texas MD Anderson Cancer Center, Houston, TX; Dana-Farber Cancer Institute-Harvard Medical School, Boston; Edmond J. Safra Center for Ethics, Harvard University, Cambridge, MA; Medecins Sans Frontieres/Doctors Without Borders, New York, NY; and The University of Sydney, Sydney Australia.
authors.forename: David
authors.initials: D
authors.lastname: Steensma
authors.affiliation: The University of Texas MD Anderson Cancer Center, Houston, TX; Dana-Farber Cancer Institute-Harvard Medical School, Boston; Edmond J. Safra Center for Ethics, Harvard University, Cambridge, MA; Medecins Sans Frontieres/Doctors Without Borders, New York, NY; and The University of Sydney, Sydney Australia.
authors.forename: Judit
authors.initials: J
authors.lastname: Rius Sanjuan
authors.affiliation: The University of Texas MD Anderson Cancer Center, Houston, TX; Dana-Farber Cancer Institute-Harvard Medical School, Boston; Edmond J. Safra Center for Ethics, Harvard University, Cambridge, MA; Medecins Sans Frontieres/Doctors Without Borders, New York, NY; and The University of Sydney, Sydney Australia.
authors.forename: Adam
authors.initials: A
authors.lastname: Elshaug
authors.affiliation: The University of Texas MD Anderson Cancer Center, Houston, TX; Dana-Farber Cancer Institute-Harvard Medical School, Boston; Edmond J. Safra Center for Ethics, Harvard University, Cambridge, MA; Medecins Sans Frontieres/Doctors Without Borders, New York, NY; and The University of Sydney, Sydney Australia.
authors.forename: Donald
authors.initials: D
authors.lastname: Light
mesh_terms: D000970:Antineoplastic Agents / Q000191:economics*; D016527:Drug Costs; D018166:Health Care Reform; D005102:Health Expenditures; D006801:Humans; D009369:Neoplasms / Q000188:drug therapy* / Q000191:economics*; D010819:Physician's Role; D014481:United States
chemical_list: D000970:Antineoplastic Agents