FOCUS OF THE WEEK
Kadcyla Approval Spurs Oncology Drug Cost Discussion
March 4, 2013, 08:00:16 AM
The FDA approval of Roche/Genentech’s breast cancer drug T-DM1 (brand name Kadcyla) last week has caused a mixed reaction from healthcare analysts.

Kadcyla has been shown in clinical studies to extend the median survival of women with HER2-positive metastatic breast cancer by several months, and this is excellent news for breast cancer patients, caregivers, and providers. In addition, main clinical trial leading to the approval of Kadcyla included 991 patients with metastatic breast cancer that were worsening despite treatment with Herceptin and a taxane chemotherapy drug. In addition to the treatment prolonging the lives of the patients, side effects were fewer. The New York Times reports that “about 43 percent of patients on Kadcyla had serious side effects compared with 59 percent of those getting the two pills.”

However, the price of treatment with Kadcyla—$9,800 per month, or $94,000 for a standard course of treatment—has left many wondering what the fate of the drug will be. To put it into perspective, that is more than double the cost of the current top-selling cancer drug Herceptin, which is estimated to cost around $4,500 per month.  It wasn’t too long ago when Memorial Sloan Kettering made headlines by refusing to use the Sanofi colon cancer drug Zaltrap because of the exorbitant cost. The protest by Memorial Sloan Kettering  eventually resulted in a major price reduction in the drug shortly thereafter.

While the groundbreaking new treatment should be celebrated, the unfortunate discussion of cost has taken center stage. Marc Engelsgjerd, MD, senior analyst,inThought, recently spoke to Medical Marketing & Media, saying that, “at some point, the ability to set such aggressive prices for oncology drugs in the US—even those like Kadcyla that extend survival—will be challenged.” In the case of Zaltrap, providers argued that the treatment was no more effective than Avastin, which was half the cost. But with Kadcyla, that is not the case, as it has proven to be more effective than competing treatments. Does that mean the pricing is here to stay? According to Gordon Gochenauer, Director, Kantar Health, the answer is yes. “We'll continue to see prices increase, particularly when the drugs bring a good value proposition by showing high efficacy, a better toxicity profile and [if it] meets an unmet need, while payers will manage utilization to a higher extent.”

Around the Web 

FDA Approves Genentech’s Kadcyla (Ado-Trastuzumab Emtansine), the First Antibody-Drug Conjugate for Treating HER2-Positive [Bloomberg]

Sanofi Halves Price of Cancer Drug Zaltrap After Sloan-Kettering Rejection [New York Times]