5174 - The price of added value for new anti-cancer drugs in France 2004-17

Background

The cost of new cancer medications is increasing prompting clinicians and policymakers to ask if newer therapies are worth their cost. We evaluated the relation between the price of new cancer drugs and their added therapeutic benefit measured by France’s High Authority of Health (HAS) and the European Society for Medical Oncology (ESMO).

Methods

We studied drugs to treat solid tumors registered by the European Medicines Agency (EMA) from 2004 to 2017. Prices were obtained from the French Official Journal. Rating for added therapeutic value were obtained from the HAS Added Therapeutic Benefit ranking (ASMR 1 being the highest benefit, and 5 the lowest) and the v1.1 ESMO-Magnitude of Clinical Benefit Scale (MCBS, 5 being the highest and 2 being the lowest). We calculated monthly treatment costs for each new drug compared with existing treatment and the correlations between price increase and added therapeutic value using Spearman’s tests.

Results

Thirty-six drugs were approved for 68 indications (with 35 first registration). The median ESMO-MCBS and ASMR scores were 4 (range 1-5) and 4 (range 2-5), respectively. Forty-eight percent and 70% of drugs had low added value according to ESMO-MCBS and ASMR, respectively. The mean monthly price for new drugs and comparators were 4,616 and 2,314 euros, respectively and increased during the observation period. For all indications there were significant but weak correlations between ESMO-MCBS and ASMR (|rho| = 0.28, p = 0.019), ESMO-MCBS and price (|rho| = 0.33, p = 0.005) and between ASMR and price (|rho| = 0.35, p = 0.004). Correlation with price was higher when considering the first indication (ESMO-MCBS, |rho| = 0.48, p = 0.004; ASMR, |rho| = 0.37, p = 0.030). There was no correlation between price increases and ASMR or ESMO (|rho|<0.2, p > 0.1).

Conclusions

Most new drugs provided low added value. On average, new drug prices increased 2,525 euros over their comparator. Prices were weakly correlated with added value, but price increases were not.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

IMéRA Institute.

Disclosure

A. Gonçalves: Travel / Accommodation / Expenses: Novartis; Travel / Accommodation / Expenses: Roche; Travel / Accommodation / Expenses: Amgen Pfizer; Travel / Accommodation / Expenses: AstraZeneca; Travel / Accommodation / Expenses: Celgene. All other authors have declared no conflicts of interest.