Q: You argue in the piece that drug prices to treat a certain kind of leukemia are too high. Why are you speaking out now? What happened?
A: The initial decision to speak out was we were developing three drugs for chronic myeloid leukemia and all three got FDA approval in 2012. But, to our surprise, all three came with a price exceeding $100,000 a year. Now one would think this has been ongoing with us for the longest time, but the reality is cancer drug prices used to be on average under $5,000 a year before 2000. And now they’ve jumped to over $100,000. So there’s a ten-fold increase in the price of cancer drugs over the past 10-15 years. And this has sneaked up on us gradually on us without anyone noticing, but we have come to a boiling point.
Q: Well, the pharmaceutical industry has responded to your paper – and to other criticisms over the years – by saying that drug prices reflect the high cost of research and the simple fact of free-market economics. What do you say?
A: They say it reflects the cost of development. And there’s the myth that it costs about $1 billion to bring a new drug to the market. The reality is that the cost of bringing a new drug to the market is probably 10 percent of that value, or less than $100 million. Well then they say we let the free-market economy take care of settling the drug prices. In the case of patented drugs, it does not seem that market competition is settling the drug prices at reasonable values. For example, in chronic myeloid leukemia there are now five drugs that do the same thing. And yet all of them are priced at $90,000 to $130,000 per year.
Q: Why is chronic myeloid leukemia a good example of a disease that could really benefit from affordable drugs?
A: Chronic myeloid leukemia was a fatal disease in the past. The average survival of patients was about three years. With these new drugs, chronic myeloid leukemia changed into an indolent disease, similar to diabetes. If the patients take the oral medicine on a daily basis, they could live their normal life. The problem is they have to spend $100,000 a year to stay alive.
Q: What should be done?
A: I think what we need to do is start a national discussion on this issue. Drug prices and cancer drug prices are the big elephant in the medical room. If cancer research is paid 80 percent by taxpayers’ money, and if most of the discoveries in cancer drugs are made in the United States, why is it that the U.S. patient pays almost twice the price of a cancer drug as they pay in Europe?
Q: Do you think it needs to come from doctors?
A: Our first pledge is to do no harm, that is the Hippocratic oath. If we believe that cancer drug prices are harming our patients, because they cannot afford them, then it is our duty and obligation to speak up. You can find numerous examples across the cancer disciplines. In lung cancer, in prostate cancer, in cancer of the bladder, in renal cancer, in melanoma. In all of these disciplines, the cancer drugs prices are coming routinely now at over $100,000 a year. I cannot find any reason for the run-up in the cancer drug prices except corporate profits.