Cancer drug costs are rising in both the United States and in Europe, but there are some important differences: US prices start high and go higher. In Europe, launch prices for cancer drugs are typically below those in the United States, and then prices fall after the product is on the market.

The difference? In Europe, regulators negotiate prices, and the United States, they don’t, according to the study authors, led by Kerstin Noelle Vokinger, MD, JD, PhD, LLM, as assistant professor of the University of Zurich who is affiliated with Harvard Medical School.

The findings were presented at ASCO20 Virtual, the annual meeting of the American Society of Clinical Oncology.

“While drug manufacturers set prices without restriction in the United States, European countries have regulations that allow national authorities to directly negotiate drug prices at launch and over time,” the study said.

Investigators tracked prices at launch and over time for 42 solid tumor drugs in this study, and compared pricing in the United States with that of Germany, England, and Switzerland. The study period covered 2009 to 2019.

The average launch prices for monthly treatment costs per patient were $15,178 in the United States versus $7049 in Germany, $7421 in Switzerland, and $8176 in England. Comparing pricing at the interquartile range, (IQR), this meant prices at launch were 215% higher on average in the United States than in Germany; 205% higher on average than Switzerland, and 186% higher on average than England.

Once drugs reached the market, prices went in different directions. Per-month treatment prices decreased over time for 36 drugs in Germany (86%), 40 drugs in Switzerland (95%), and 38 (90%) in England.

However, US monthly treatment costs were more likely to rise after a drug reached the market. “By contrast, prices of 8 (19%) drugs decreased, while 34 (81%) increased post launch in the United States, with total additional expenses of $128,192 for monthly treatment costs.”

In Europe, post-launch price decreases resulted in monthly treatment cost savings of $86,744 in Germany; $44,936, Switzerland; and $1744, England.

“These price disparities continue to increase substantially after market entry since cancer drug prices, in general, decrease over time in Europe and increase in the US,” investigators said.

“Spending on cancer drugs could be reduced in the United States if it adopted the principles used to more effectively negotiate drug prices in Europe,” they noted, adding that the launch prices of cancer drugs have risen more than 100-fold since 1965.

In Europe, they said, national authorities are permitted to directly negotiate drug prices at launch and over time. In the United States, private health payers that provide coverage for Medicare beneficiaries have the power to negotiate Part B drug costs; however, Medicare is prohibited from negotiating drug prices.

For a related story from ASCO20 Virtual on access to cancer drugs and cost, click here. Learn more about ASCO20 Virtual by visiting our conference page.

Reference

Vokinger KN, Daniore P, Lee CWC, et al. Launch prices and price developments of cancer drugs in the United States and Europe. J Clin Oncol 2020;38(suppl; abstr 2006): doi: 10.1200/JCO.2020.38.15_suppl.2006