Price Controls to Ration Cancer Drugs

October 1, 2013   Rationing

Price Controls to Ration Cancer Drugs

By Wesley J. Smith

QALYs2reI always say: If you want to see where things will go wrong next in society, read the professional journals.

An article published in the Journal of Clinical Oncology advocates that the government set a “just price” for all cancer drugsFrom the article (my emphasis):

Finally, we must challenge the status quo that sets drug prices arbitrarily without regard to the real value of a drug.

Assuming the government should have the power to dictate price–a problematic proposal, at best–how to do that? Quality of life!

The value of a new cancer drug should be measured by one of several parameters: one, improving survival or PFS [“progression-free survival”–how long a patient lives before his cancer worsens] (particularly important as an early surrogate end point for indolent tumors); two, improving quality of life; three, reducing/alleviating adverse effects compared with similar approved drugs or reducing toxicities of cancer drugs; and four, reducing cost.

To that end, we propose a value-based system for setting the initial price. Providers, regulators, patients and advocates, representatives of insurance and pharmaceutical companies, and other interested parties should all be involved in the discussion of initial pricing. The benefit quantified for FDA drug approval should be integral to drug pricing. Drug pricing could involve established measures of CE, life-years, or QALYs.


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