Oncology Drug Pricing Variation Across Europe Highlighted

The best available information indicates that the per vial price of oncological agents significantly differs between European countries

medwireNews: Research reveals a significant lack of consistency and transparency in the cost of new oncology drugs across 16 high-income countries in Europe, as well as in Australia and New Zealand.

The study, published in The Lancet Oncology, found that in June 2013 the difference between the lowest and highest ex-factory prices for 31 anticancer agents varied from 28% to 388% between countries.

For example, the cost per vial of gemcitabine ranged from €43 in Australia to €209 in New Zealand, while zoledronic acid was €128 per vial in Greece but €330 in New Zealand.

Although there were low and high outlier prices for specific drugs in different countries, prices in Greece, Portugal, Spain and the UK tended to be on the lower range of prices while those in Switzerland, Germany, Denmark and Sweden were at the high end.

However, Sabine Vogler, from the Austrian Public Health Institute in Vienna, and co-authors say that they were able to retrieve price data in all 18 countries for just five of the drugs, with ofatumumab and erlibulin price information only available for 10 and 11 countries, respectively.

“Information about drug price information is scarce and not transparent by confidential discounts and similar arrangements (eg, managed-entry agreements)”, they emphasize.

“As policy makers cannot consider such agreements because they are confidential, they risk overpaying when setting prices through external price referencing.”

In addition, the authors of an accompanying comment surveyed the costs per vial of nine targeted agents in the 51 European Organization of Cancer Institutes (OECI) and the non-OECI members of Cancer Core Europe.

Reporting responses from 21 centres in 15 countries, mainly received in June and July 2015, Wim van Harten, from the Netherlands Cancer Institute in Amsterdam, and team say that listed prices varied by up to 92% between countries and by up to 58% within countries, with varying degrees of discounting quoted.

“If a pattern can be detected, we conclude that pricing seems to be highest in the wealthier countries such as the Netherlands, but a strict association between [gross domestic product] per person and pricing level could not be established”, they write.

The commentators now call for “joint action by countries and medical societies with the pharmaceutical industry, since fast and equitable access to promising new drugs is important to improving treatment results.

“The societal challenge is to combine the development and availability of promising new drugs with the sustainability of our system”, they write. “All parties involved must agree innovative and sustainable business models to ensure fast access to relevant drugs for patients with cancer.”

References

Vogler S, Vitry A, Babar Z-U-D. Cancer drugs in 16 European countries, Australia, and New Zealand: a cross-country price comparison study. Lancet Oncol 2015; Advance online publication 3 December. DOI: dx.doi.org/10.1016/S1470-2045(15)00449-0

van Harten WH, Wind A, de Paoli P, Saghatchian M, Oberst S. Actual costs of cancer drugs in 15 European countries. Lancet Oncol 2015; Advance online publication 3 December. DOI: dx.doi.org/10.1016/S1470-2045(15)00486-6

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