A new kind of cancer drug brings promise—and major costs

Standard course of treatment could cost $143,000 annually

A new class of cancer treatments, known as PD-1 inhibitors, recently debuted on the Japanese market at an average annual cost of $143,000 per patient—which could be a sign of things to come in the U.S. drug market, Peter Loftus writes in the Wall Street Journal.

 According to the Journal, PD-1 inhibitors use a person's immune system to fight tumors—including melanoma, which often kill patients within a year of diagnosis if they have metastasized to other parts of the body.

J. Leonard Linchtenfeld, deputy chief medical officer for the American Cancer Society says, the drugs "have the potential to be game-changers for a lot of people" because trial patients have had "meaningful, long-term responses." However, he says that rising treatment prices for new cancer treatments are a mounting concern for patients and their families, who often must pay high co-payments.

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Details of Japan's PD-1 inhibitor release

This week, Ono Pharmaceutical and Bristol-Myers Squibb debuted PD-1 inhibitor Opdivo, whose generic name is nivolumab, in Japan. The drug has been shown to significantly decrease mortality rates of patients with metastasized melanoma. About 62% of patients receiving the drugs were still alive one year after beginning therapy, while 43% were still alive after two years.

The drug will cost 729,849 yen per 100-milligram of nivolumab, which is infused every three weeks at a dose based on a patient's weight. Using the average Japanese patient weight of 132 pounds, the yearly cost of a nivolumab treatment would be 15 million yen, or about $143,000.

Bristol-Myers to market Opdivo in U.S.

Bristol-Myers plans to submit Opdivo for U.S. regulatory approval for melanoma treatment by the end of the month. In addition, the company is expected to apply for U.S. approval to market the drug as a treatment for a type of lung cancer by the end of 2014.

Should government be more involved in regulating pricing?

The company says it has not decided how much it will charge form the drugs, saying the prices of their drugs are based on "the value they deliver to patients and society, the scientific innovation they represent, and the investment required to support" drug research and development.

Typically, prices for brand-name drugs in Japan are 18% lower than the same treatments in the United States because of price cuts imposed by Japan every two years, according to the Department of Commerce. U.S. pharmaceutical analysts predict that the therapies will cost more than $100,000 per patient annually, although a standard duration of treatment has not yet been established.

Yervoy, a similar cancer immunotherapy that Bristol-Myers has been marketing since 2011, costs about $120,000 per patient for a standard course of treatment (Loftus, Wall Street Journal, 9/4). 

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