The cost of cancer treatment is climbing, and healthcare advocates are increasingly worrying that skyrocketing cancer medication costs could take a big toll on the healthcare industry in the coming decade. A recent study conducted by the Memorial Sloan Kettering Cancer Center, a leading provider of care to cancer patients, highlights five recently-approved cancer drugs that come with jaw-dropping price tags. Although these drugs offer patients increasingly better outcomes, they do so at a staggering price.
No. 5: Xofigo, $12,657 monthly cost per patient
Bayer AG's (OTC:BAYRY) Xofigo won the FDA go-ahead in May 2013 for use in late stage prostate cancer that has spread to the bones, but not to other organs. It's intended for use in patients that have failed on prior therapies, and it's put up solid results during its clinical trials.
In trials, the drug, which works by binding with minerals in the bone to deliver radiation directly to bone tumors, helped patients live a median 14 months after treatment, versus 11.2 months for patients receiving a placebo.
So far, the drug hasn't been as big of a commercial success as other recently-approved prostate cancer drugs, including the billion dollar blockbuster medicines Zytiga and Xtandi, but at current exchange rates, it still generated $171 million in sales last year, up from $45 million in 2013.
No. 4: Cyramza, $13,256 monthly cost per patient
Eli Lilly's (NYSE:LLY) Cyramza was first approved for the treatment of stomach cancer in April 2013; however, since then it's also notched FDA approvals for use in both gastric cancer and non-small cell lung cancer, too. The lung cancer indication is the biggest of the three markets that Cyramza is approved to treat. According to the National Cancer Institute, 224,210 Americans are diagnosed with lung cancer every year, and the vast majority of these are non-small cell lung cancer.
Cyramza works by cutting off the blood supply necessary for tumor growth, and the drug -- like Xofigo -- is intended for use in patients whose disease has progressed following the use of other treatment options.
In trials, non-small cell lung cancer patients receiving Cyramza, plus the chemotherapy docetaxel, lived an average 10.5 months, compared to 9.1 months for patients receiving docetaxel alone.
Since launching Cyramza in the second quarter of last year, sales have grown steadily and reached $33.6 million in the fourth quarter. That fourth quarter performance gives Cyramza a sales run rate of $134 million, but sales could head much higher this year given that the lung cancer approval was just awarded in December.
No. 3: Zykadia, $13,672 monthly cost per patient
Last April, Novartis AG (NYSE:NVS) got the FDA to green light Zykadia four months ahead of schedule as a treatment for a very specific type of late-stage non-small cell lung cancer known as ALK-positive NSCLC. Zykadia is approved for use after patients have seen their disease return following treatment with crizotinib, the only other drug approved for this rare patient population. According to the FDA, only 2% to 7% of NSCLC patients are ALK positive.
During clinical trials, about half of Zykadia patients saw tumors shrink; however, despite that efficacy and its sky-high price tag, Zykadia hasn't become a big revenue maker for Novartis. In 2014, Zykadia sales totaled just $31 million.
No. 2: Lenvima, $13,945 monthly cost per patient
Eisai (OTC:ESALY) got FDA approval for Lenvima in February and wasted little time in setting a price that makes it the second most expensive oncology drug approved by the FDA since 2011.
The drug will be used to treat the most common variation of thyroid cancer, which is known as differentiated thyroid cancer, or DTC. Again, like the other drugs in this list, the approval is for use in patients who, despite receiving a previous therapy, have seen their disease progress.
Lenvima blocks proteins that cancer cells use to grow and replicate, and the drug posted seemingly remarkable results during clinical trials. Patients taking Lenvima lived a median 18.3 months without seeing their disease progress, while patients receiving a placebo saw their disease progress after just 3.6 months.
According to the National Cancer Institute, 62,980 Americans are diagnosed with thyroid cancer annually, and while most of these patients are effectively treated with existing therapies, some are not. As a result, Lenvima's addressable patient population -- at first -- may be small; however, Eisai is exploring Lenvima's potential in other cancers, which could significantly expand its use over time.
No. 1: Blincyto, $64,260 monthly cost per patient
While the previous four drugs in this list boast steep monthly price tags, their costs aren't nearly as jaw-dropping as Amgen's (NASDAQ:AMGN) recently-approved Blincyto.
In December, the FDA approved Blincyto for a rare form of acute lymphoblastic leukemia, or ALL. The drug is used in patients with Philadelphia chromosome-negative precursor B-cell ALL, a condition in which the bone marrow makes too many B-cell immature white blood cells. Only 6,000 people in the U.S. will be diagnosed with ALL this year, and only some of them will have this specific variation.
In those patients, Blincyto helps a patient's immune system find and destroy leukemia cells. Since it addresses a significant unmet need among a small number of patients, Amgen has priced it at a significant premium to other cancer therapies. We'll find out whether or not that translates into meaningful sales as the year progresses, but analysts think that Blincyto sales could total in the hundreds of millions of dollars in sales per year.
Tying it together
Sky-high pricing isn't a new phenomenon within the healthcare sector, and the trend toward more expensive medicine isn't limited to oncology drugs. Prices are trending up across all specialty medicines.
According to Express Scripts, a national pharmacy benefit manager, spending on specialty drugs -- like these oncology medicines -- grew 31% year-over-year last year, mostly because of higher prices.
Whether or not pricing and innovation are so tightly tied together that reining in costs would mean imperiling the next generation of medicine is a raging debate, but for now it appears that cancer costs will continue to climb. According to the National Cancer Institute, the amount of money that Americans will pay for ongoing cancer care will climb 32% to $157 billion between 2010 and 2020, implying that specialty drugmakers will be poised to profit over the next decade.