The treatments would be much less expensive to develop than what the laboratories say. The selling prices would thus be unjustified.
What is the real cost of developing a cancer drug? This is the question that American researchers have tried to answer. After the debate on the price of Sovaldi in France, the treatment for hepatitis C, the debate on the cost of drugs is far from over. And this study could well throw a new pavement in the pond.
In one article published in the journal JAMA, they come to the following conclusion: their development would be three to four times cheaper than what the laboratories claim.
Seven dollars per dollar invested
For years, the benchmark has been that provided by researchers at the Tufts Center for the Study of Drug Development, who reported that between the time of conception and launch, a drug cost approximately $ 2.7 billion to produce.
But according to the latest calculation from the Knight Cancer Institute in Portland (United States), based on 10 recent cancer treatments, its median cost would rather be around $ 760 million: half costs more, and half costs less.
And together, these 10 treatments brought in $ 67 billion for labs. A juicy return on investment: it is equal to seven times the investment – even if among the 10, one drug has not been profitable.
Forgotten hiccups?
As expected, the reactions of the laboratories were not long in coming. “What this study tells us is that it is opportune, from a business point of view, to go and buy winning lotto tickets”, criticizes Daniel Seaton, spokesperson for the Biotechnology Innovation Organization, the world’s largest lobby for the biotechnology industry. He reproaches the researchers for not having taken into account all the research carried out by these same laboratories, and in particular, those which were unsuccessful.
An accusation disputed by Drs. Vinay Prasad, an oncologist at the University of Oregon, and Sham Mailankody, of the Memorial Sloan Kettering Cancer Center in New York. For example, they included in their figures drugs developed by the same laboratories, but which have not received authorization from the US FDA, the US drug agency.
They cite the example of ibrutinib, an anticancer. Of four drugs developed by the Pharmacyclics company, it is the only one to receive FDA clearance in 2013. Together, their development cost $ 388 million, according to company figures. The ibrutinib license was subsequently sold for $ 21 billion to Janssen Biotech. A profit greater than 5,000%, even counting the misfires!
New economic model
However, the study appears to have some limitations. It is only interested in treatments developed by “small” laboratories, which do not have the force of Novartis, Sanofi or GSK. Interesting treatments for patients, which would sometimes encourage the FDA to authorize smaller clinical trials, and therefore less expensive for these smaller structures, explains Patricia Danzon, an economist at the University of Pennsylvania, in the New York Times.
A criticism that would hold less and less, because this economic model is tending to become widespread: small structures develop molecules, which they resell at a high price to the giants of the market, who then take care of their marketing.
But, whatever the economic model chosen, the calculation is the same, according to Dr. Aaron Kesselheim, in charge of the cost of treatments at Brigham and Women’s Hospital in Boston. For him, regardless of the development cost, it will not influence the prices. “They are fixed in relation to what the market can support,” he said.
And it looks like the market is generous. Kymriah, the first gene therapy intended to treat childhood leukemia, has just been approved by the FDA. Its price negotiated by Novartis: around 400,000 euros.
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