End of life or end of the road? Are rising cancer costs sustainable? Is it time to consider alternative incentive and funding schemes?

Abstract

The number of cancer therapies is increasing. Treatment costs, largely reflecting increasing prices, are also increasing. The regulatory process is increasing in intensity. Countries have initiated risk sharing agreements and/or special cancer funds to accommodate this expenditure growth. Given increasing pressures elsewhere on healthcare budgets, even this response is not sustainable. With many more cancer drugs in the pipeline and the prospects of combination therapy, it is unlikely that the existing policies being applied by payers can maintain budget constraints. Unless payers increase reimbursement and/or extend flexible reimbursement schemes, solutions will be required to ensure access to new cancer therapies – this includes looking at ways of reducing R&D costs. This perspective outlines the problems faced and suggests some solutions.

Keywords:

• current reimbursement strategies
• increasing treatment costs
• oncology
• patents and prizes
• R&D costs

Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.

Key issues

• The number of cancer therapies is increasing.

• Treatment costs in oncology are also increasing.

• The regulatory process is increasing in intensity.

• Various solutions are currently addressing these issues: including risk sharing agreements and/or special cancer funds.

• Given increasing pressures elsewhere on healthcare budgets, this response is not sustainable.

• With more cancer drugs in the pipeline and the prospects of combination therapy, it is unlikely that the existing policies being applied by payers can maintain budget constraints.

• Other solutions will be required to ensure access to new cancer therapies.

• This includes looking at ways of reducing R&D costs.

• The current expenditure growth in this area is not sustainable.

Notes