1. The assertion of Steve Pearson of the Institute for Clinical and Economic Review (ICER) that the combinations will cost more is inaccurate. In a recent report I pointed out that Pearson estimates the cost of combining three drugs for multiple myeloma using list prices of all drugs in making the case for ‘group’ discounts. In fact, the list price of such medicines are already discounted by about 30-50 percent because of rebates drug companies provide. Pearson never notes that these rebates are pocketed by insurers and pharmacy benefit companies even as they force patients to pay 30 percent of the list price of products.
2. Most treatment combinations reduce the cost of other more expensive services and care. Indeed, I co-authored two abstracts presented at the same ASCO meeting Loftus attended demonstrating that combinations of cancer drugs matched to specific patients cost less or about the same at less effective treatments. Similarly, Intermountain Health published two studies the came to the same conclusions.
3. Pearson and others also ignore the savings and benefits to patients by using combinations that reduce the need for second and third line therapies as well as the end of life care that is more likely required when combinations are not used.
4. Finally, cancer costs increase mainly because people are living longer. ICER notes “…additional progression-free survival leads to higher costs” and recommends restricting use of new medicines to address this ‘problem.’ So letting people die becomes the de facto discount.
Groups like ICER believe that we need to spend less on cancer drugs they define as not valuable because doing so " often leads to waste that saddles our children and their children with future budget deficits based on our inability to objectively look at the evidence and value of new drugs. We’re siphoning off resources for other things we need like better schools and more resources for local police, roads and bridges."
In fact, spending on cancer drugs – which is less than 1 percent of total health care spending – increases well-being and prosperity by increasing life expectancy. Reporting based on misinformation could lead to policies that deny patients access to medicines that produce such benefits including more tax revenue for filling potholes. Loftus and other journalists should look at how ICER leads them astray. Also, has anybody checked to see if ICER doesn't run a highway construction company?