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High Price Of Cancer Treatment Drugs Is 'Unsustainable,' Doctor Says


In Chicago, thousands of scientists and doctors are attending the annual meeting of the American Society of Clinical Oncology. The meeting, not too surprisingly, is heavily sponsored by the drug industry - not exactly the place where people speak out against the pharmaceutical industry. But Dr. Leonard Saltz, chief of gastrointestinal oncology at Memorial Sloan Kettering Cancer Center, caused a mini storm when, on Sunday, he openly criticized the high cost of cancer treatments. With drug combinations in the hundreds-of-thousands of dollars, patients simply can't afford them. Dr. Saltz joins us from the conference. Welcome to the program.


CORNISH: What's striking me about your speech is you said that cancer drug prices are not related to the value of the drug. What's going on there?

SALTZ: Well, the specific drugs that were presented at the plenary session here were actually showing quite a lot of benefit, but when I broke down what it would cost to treat an average-sized American with those drugs for a year, it would've been $300,000 per patient per year. And when we talk about value, we have to talk about the benefit as well as what it costs.

CORNISH: Now, pharmaceutical companies say that this is the cost of developing new drugs - right? - that they take on a great deal of risk in doing it.

SALTZ: And we certainly need to consider the pharmaceutical companies position in deciding how we're going to pay for drugs. But right now we're paying for the drug whether it works very well or whether it works just a tiny, little bit.

CORNISH: Do you run the risk of discouraging drug companies from investing in new medicines?

SALTZ: I don't think that's a fair concern. I think that's one of the talking points of the pharmaceutical industry, but I don't believe it's true. Ultimately, the industry is going to invest in development of drugs because that's how they're going to make a living.

CORNISH: You've also argued that one way to control prices might be to allow Medicare to negotiate prices directly with pharmaceutical companies. This is currently banned by law in part because lawmakers argue that the private companies that are currently giving out this benefit they do a better job negotiating cost than the government could. Is it to you that this is no longer the case?

SALTZ: I don't think it's a fair argument. Medicare is the single largest purchaser of the drugs, and the idea that the largest purchaser should have to pay any price that the drug company sets simply doesn't make sense. And that's really what it means when we say that they can't negotiate price. Once the Food and Drug Administration approves a drug for a particular indication, the Center for Medicare and Medicaid Services has to buy that drug at any price that the drug company chooses to set. And that's not a market. That's a very one-sided situation.

CORNISH: You've talked about there being a taboo among doctors in terms of really discussing this openly. What is that?

SALTZ: Well, we've wanted to have this sense in our society for a very long time that health and life is above consideration of cost. But that's probably always been unrealistic. But as I showed in my talk at the meeting, the industry has been putting a dollar value on the cost of extending life regularly and increasing that regularly for quite some time. So there is always a price to the considerations that go into whether we're going to use a particular treatment or particular drug, a particular procedure. And it's really not realistic to keep that discussion out of the clinic and away from patients.

It's even more important now because more and more patients are feeling the financial burden of these very expensive treatments. Patients are having very high copays, high percentage copays, and we've seen lots of data indicating that a cancer diagnosis creates real financial hardship for patients, is one of the major causes of personal bankruptcy, and clearly, the high dollar drugs that are involved are a major component of this.

CORNISH: Now that there's been some time for people to respond to the speech, what are you hearing from doctors?

SALTZ: It was really my intention not to alienate anyone in this discussion but rather to get the point across that we have an unsustainable situation that is going to lead to increased disparities in healthcare and an inability for people to get the drugs they need.

CORNISH: Dr. Leonard Saltz - he's the chief of gastrointestinal oncology at the Memorial Sloan Kettering Cancer Center. Thank you so much for speaking with us.

SALTZ: My pleasure. Transcript provided by NPR, Copyright NPR.

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