Innovation

Falling Cancer Rates And The International Pricing Model

January 17, 2019 12:18 pm

The American Cancer Society (ACS) announced last week that cancer deaths in the United States fell 25 percent over the last 25 years.

 

While many news stories (rightly) zeroed in on the decline in smoking as one cause for the drop in cancer deaths, as The Wall Street Journal noted, new drugs, including immunotherapies, “are beginning to transform the treatment of many cancers …” Among the ACS’ findings: colorectal cancer death rates declined 53 percent from 1970 to 2016 among men and women “because of increased screening and improvements in treatment.”

 

In reporting the ACS data, the New York Post noted hepatitis C was once cited as the reason for the rise in liver cancer. Now, according to the World Health Organization, “Antiviral medicines can cure more than 95 percent of persons with hepatitis C infection, thereby reducing the risk of death from liver cancer …”

 

While last week’s news was extraordinarily positive, the ACS also projected there will be 1.76 million new cancer cases diagnosed in the United States this year.

 

Some of these patients eventually may benefit from treatments not on the market today, and lawmakers must consider that fact when debating drug prices.

 

A few weeks before releasing its latest cancer statistics, the ACS submitted comments to the U.S. Department of Health and Human Services (HHS) opposing the Trump administration’s proposal to use the International Pricing Model (IPI) for Medicare Part B Drugs. The ACS noted “cancer patients and survivors rely on drug therapies for life-saving treatments.” As such, the comments argued, “[I]t is paramount that any new payment model must ensure that beneficiaries have access to medically necessary treatments in the setting that is best for them.”

 

In that regard, the ACS found the proposal wanting.

 

The IPI model “as written,” the ACS said, “could actually make it harder for cancer patients, especially those living in rural areas, to find the right provider to treat their cancer with the right drug.” The ACS concluded, “We cannot sacrifice this patient access for program savings that may or may not materialize, based on price-setting processes that no American citizen can control.”  The ACS also asked that, if HHS moves forward, that it exempt oncology drugs from its model “until significant guardrails are in place to ensure that beneficiaries maintain timely access to their oncology services.”

 

The ACS is not the only cancer patient advocacy group that opposes the IPI. As Healthcare Finance reported, the Community Oncology Alliance urged HHS not to move forward with the IPI, because “it has serious concerns about the impact” the model would have “on the care received by patients with cancer ...” The AARP also expressed concerns, arguing the IPI could lead to the use more expensive drugs since “an add-on payment of six percent for a more expensive drug” would generate “more revenue than six percent of a lower priced drug.”

 

Cancer rates are declining due to a confluence of factors, but biopharmaceutical innovation certainly was one reason for last week’s good news. Misguided policy proposals could mean future statistics aren’t as positive.