The cost of oncology drugs has skyrocketed recently. Many newly approved drugs have modest survival benefits of only a few extra months. In USA, newer oncology drugs place a direct heavy economic burden on patients who make huge co-payments out of pocket (Saltz JCO 2015;33:1093–4). In UK the burden falls on the taxpayer. A face to face survey was done to assess UK public's perception of reasonable price for a course of chemotherapy drug relative to their potential benefits.
A ‘tick box’ survey form with 15 price bands (low to high) including a free text box was used. (Price Bands: 500K). Place of recruitment: (1) Market Town of Chesterfield: 20 recruited,56 declined (2) City of Nottingham 61 recruited, 23 declined. Recruitment period: March 2015. Survey done by Clinical research nurse or medical student on oncology elective. The regional ethics committee advised that a formal ethical approval is not needed for public surveys in public places.
Female 53%; Mean age 36 yrs (range 16 to 87 yrs). Subjects suggested a significantly lower value as a reasonable price for a course of cancer drugs even when drugs have significant curative potential. (table). Only a small minority felt that drug costs of more than 100,000 British pounds are reasonable . Because UK has a taxpayer funded health service, UK public probably have very poor knowledge about the actual cost of chemotherapy drugs.
The survey results indicate that the UK public might be willing to politically support value-based-commissioning if it is done in a fair and explicit manner.
|What price do you think it is reasonable for a pharmaceutical company to charge for the chemotherapy drug…………||Less than 10,000 British pounds||10,000 to 100,000 British pounds||More than 100,000 British pounds|
|If drug cures 1 in 2 cancer patients (50% cure rate)||58%||27%||15%|
|If drug cures 1 in 5 cancer patients (20% cure rate)||67%||22%||11%|
|If drug does not cure but makes cancer patients live longer by an extra 12 months||67%||23%||10%|
|If drug does not cure but makes cancer patients live longer by an extra 6 months||69%||26%||5%|
|If drug does not cure but makes cancer patients live longer by an extra 3 months||83%||17%||0%|
|If drug does not cure but makes cancer patients live longer by an extra 1 month||89%||10%||0%|
|If drug does not cure and does not make a cancer patients live longer but relieves cancer related pain and other symptoms||79%||20%||1%|
chi-square test for all qs p =
Clinical trial identification
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All authors have declared no conflicts of interest.