ASCO Outlines Solutions for More Affordable Cancer Drugs

In a recently released position statement, the American Society of Clinical Oncology (ASCO) has outlined a pathway that would address the rising costs of cancer drugs in the United States.

The position statement tackles the urgent issue of the cost of specialty cancer drugs and the financial toxicity that can result for patients. It cites the nuances of the US healthcare marketplace as well as the rapid growth in available drugs as some of the reasons it will require a multifaceted approach to control these rising prices while ensuring patient access to care and innovative drug development.

ASCO has called for raising the standards for drugs to be considered clinically effective, which would ensure that approved drugs yield significant value to patients, relative to their cost. The statement also recommends utilizing value-based pathways to guide drug utilization, and pricing drugs based on the indications they are used for or the outcomes they produce in patients. However, the statement emphatically recommends against using payment bundles in oncology, since they are too homogenous and could push providers to make subpar clinical decisions.

ASCO’s statement also outlines some regulatory steps that could be taken to lower drug pricing, such as shortening the market and data exclusivity windows for biologic drugs and outlawing several tactics that brand-name drug makers use to discourage competition. It cautiously mentions the possibility of importing lower-priced drugs from foreign countries, but notes that there are safety risks associated with this practice that have the potential to increase drug prices in the overseas markets.

The statement included some positions aimed at insurers who cover the cost of cancer drugs:

• ASCO strongly opposes tiered formularies, which could put some oncology therapies out of financial reach for patients.
• Allowing Medicare to negotiate discounts with drug makers could lower prices, but may have unintended consequences if the program can deny coverage of a costly drug.
• Implementing value-based pathways in Medicare may be a feasible way to establish value based on the recommendations of the scientific community, not the government.

Finally, the statement emphasizes the importance of drug pricing transparency, which would let payers and patients examine the relationship between development costs and drug pricing and hold drug companies accountable for any apparent efforts to gouge prices.

In summary, ASCO recognized that the complex problem of cancer drug costs does not have a simple solution, but coordinated efforts to define value, experiment with pricing initiatives, and drive innovation will be crucial.

"Drug pricing is clearly too complex and political to tackle without evidence-based solutions," said ASCO CEO Clifford Hudis, MD, FACP, FASCO, in a press release announcing the release of the position statement. "We're focused on finding out what works and what the potential downsides and unintended consequences might be with each intervention. However, ASCO believes we must develop approaches that will protect patients from rising costs while improving care."