FiercePharma's Factless Farce

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  • 05/29/2015
Fierce Pharma has long been a reliable source of misleading information about the cost of medicine because it never mentions value. 

The latest post by Tracy Staton -- essentially a rewrite of an Express Scripts blog complaining about the cost of medicines --  lives up to that proud journalistic heritage.   Staton once again obsesses about the amount of money spent on two or three cancer drugs without mentioning their impact.  I think it’s because no matter the value of such innovative medicines, the profits and prices are too high for Staton.  

"As the American Society of Clinical Oncology meeting approaches, the pharmacy benefits manager released some numbers on cancer drug spending. The top line? Spending on cancer meds grew by more than one-fifth last year, with a 9% increase in use and almost 12% increase in prices.

Prime suspects for that increase? The leukemia treatment Gleevec, from Novartis ($NVS), which boasts the biggest share of the market at 12.5%. Fellow blood cancer treatment Revlimid--the multiple myeloma therapy from Celgene ($CELG)--came in close behind with 10.8% of pharmacy benefit spending.
She will never be convinced. " 

Let's take a look at those prime suspects and what they are guilty of.  

All Gleevec did was launch a revolution in personalized medicine and an array of medicines that allow people with CML to live full lives.  According to my colleague Tomas Philipson and his research group:  The TKI drug class in CML therapy has created more than $143 billion in social value. Approximately 90% of this value is retained by patients and society, while approximately 10% is recouped by drug companies...
The introduction of TKI drugs to treat CML has generated significant social value as a result of survival gains, the vast majority of which has accrued to patients.

What about treatments  for multiple myeloma developed by Celgene, Takeda and others since 1998:

Frank LIchtenberg concluded: 

"(A)lmost two-thirds (0.99 years) of the 1997-2005 increase in the life expectancy of American myeloma patients was due to an increase in the number of chemotherapy regimens now preferred by specialists. Based on a back-of-the-envelope calculation, this means that the cost per US life-year gained from post-1997 chemotherapy innovation is unlikely to have exceeded $46,000. We also investigate the impact of chemotherapy innovation on the myeloma mortality rate using longitudinal country-level data on 38 countries during the period 2002-2012. Countries that had larger increases in the number of chemotherapy regimens now preferred by specialists had larger subsequent declines in myeloma mortality rates, controlling for myeloma incidence.

Put another way,  people with myeloma added 360,000 life years since 1997, worth about $54 billion.  

Finally,  Staton ignores the contribtuion of cancer drug spending on total health expenditures.  

As the amount spent on new medicines increases, the cost of treating such diseases has declined
In 2011, 11.4 percent of total cancer expenditures were for prescription medicines as compared with 3.6 percent in 2001
The proportion spent on inpatient hospital stays declined from 47 percent in 2001 to 35 percent I 2011.

Cancer spending as a percent of total health care spending and GDP actually has declined.   Prescription drugs as a percent of total health care spending has remained at about 9 percent since 2000 and is projected to remain 9 percent for the next decade.  All the while cancer drugs make up more and more of spending on drugs and cancer care.

So maybe the takeaway is that more spending on the newest and most expensive drugs is a good thing.. or at least not portrayed as a criminal activity by FiercePharma.  

Fierce Pharma has to decide whether it has a responsibility to correct her bias by including other viewpoints or by providing greater editorial direction to include information that places the price and cost of medicines for cancer and other life threatening or disabling diseases in context.

My bet is that it will continue to demagogue an issue short on facts and chock fill of misplaced anger. 


Center for Medicine in the Public Interest is a nonprofit, non-partisan organization promoting innovative solutions that advance medical progress, reduce health disparities, extend life and make health care more affordable, preventive and patient-centered. CMPI also provides the public, policymakers and the media a reliable source of independent scientific analysis on issues ranging from personalized medicine, food and drug safety, health care reform and comparative effectiveness.

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