title: The high price of anticancer drugs: origins, implications, barriers, solutions.
abstract: Globally, annual spending on anticancer drugs is around US$100 billion, and is predicted to rise to $150 billion by 2020. In the USA, a novel anticancer drug routinely costs more than $100,000 per year of treatment. When adjusted for per capita spending power, however, drugs are most unaffordable in economically developing nations, such as India and China. Not only are launch prices high and rising, but individual drug prices are often escalated during exclusivity periods. High drug prices harm patients - often directly through increased out-of-pocket expenses, which reduce levels of patient compliance and lead to unfavourable outcomes - and harms society - by imposing cumulative price burdens that are unsustainable. Moreover, high drug prices are not readily explained by rational factors, including the extent of benefit patients are likely to derive, the novelty of the agents, or spending on research and development. Herein, we summarize the available empirical evidence on the costs of anticancer drugs, probe the origins and implications of these high costs, and discuss proposed solutions.
authors.affiliation: Division of Hematology and Medical Oncology, Knight Cancer Institute, Department of Preventive Medicine and Public Health, and Center for Health Care Ethics, Oregon Health and Science University, Portland, Oregon 97239, USA.
authors.forename: Vinay
authors.initials: V
authors.lastname: Prasad
authors.affiliation: Ponce Health Sciences University-School of Medicine, P.O. Box 7004, Ponce, Puerto Rico 00716-2347, USA.
authors.forename: Kevin
authors.initials: K
authors.lastname: De Jesús
authors.affiliation: Myeloma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, New York 10065, USA.
authors.forename: Sham
authors.initials: S
authors.lastname: Mailankody
mesh_terms: D000970:Antineoplastic Agents / Q000191:economics*; D003363:Cost Control / Q000379:methods; D003906:Developing Countries; D016527:Drug Costs / Q000706:statistics & numerical data* / Q000639:trends; D055808:Drug Discovery / Q000191:economics; D004345:Drug Industry / Q000191:economics; D005102:Health Expenditures / Q000706:statistics & numerical data; D006801:Humans
chemical_list: D000970:Antineoplastic Agents