Déjà vu: DMTs are simply too expensive

Déjà vu: MSologists are having the same problem as our colleagues in oncology with the price of DMTs. #MSBlog #MSResearch

Editorial. Sticker shock. Nature Medicine 19, 653 (2013) doi:10.1038/nm.3244 Published online 06 June 2013

…. A recent plea by oncologists condemning inflated prices for some cancer drugs has ignited a debate on this topic between clinicians and pharmaceutical companies and highlights the need for a broader assessment of drug valuation…..

…… In a recent commentary published in the journal Blood, an international group of more than 100 clinicians and scientists criticized pharmaceutical companies that market costly cancer drugs to treat chronic myeloid leukemia (CML). The authors argued that the prices of six CML drugs have reached unsustainable levels that jeopardize patients’ treatments and economic well-being…..

“I have heard similar mutterings from US colleagues.”

…..The article has sparked reactions that underscore the complexity of the issue, which encompasses questions of how drug values are determined, where moral boundaries are drawn and what mechanisms can be employed to reduce the divide between commercial interests and patient welfare…..

…. In response to this disparity, some regulatory agencies and insurance companies have refused to approve payment for certain high-cost treatments. In the UK, the National Institute for Health and Care Excellence (NICE) evaluates the cost-effectiveness of drugs that have been approved by the European Medicines Agency (EMA) and issues funding guidance to the National Health Service (NHS). The NHS covers the cost of drugs that NICE approves for a given disease…

….. In the US, medical insurance companies have also refused to reimburse patients for some cancer drugs….

….. Medical expenses are the most frequent cause of personal bankruptcy in the US, and the high cost of drugs is a factor in poor adherence and treatment failure….. 

….. Ultimately, legislation that would allow healthcare agencies to negotiate directly with drug companies or that would cap drug prices might be needed to curtail further cost escalation of cancer treatments. Pharmaceutical companies realize that not everyone can pay for their drugs and have created patient assistance programs, some of them benefiting underdeveloped countries or underprivileged segments of the population…..

“The issue of expensive DMTs has been aired many times on this blog. It is interesting to see that it is not limited to our field. It is clear the status quo is unsustainable. What will be the outcome?”
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4 thoughts on “Déjà vu: DMTs are simply too expensive”

  1. Sounds like we need a bit of radical campaigning – but when dealing with difficulties in everyday life, this becomes low down on the list of priorities, sadly

    1. I agree; my problem is that I only have 24 hours in my day and I already spend most of them doing MS-related activities. I think we need to crowd source this one. Any volunteers?

  2. I know this comment hits the ethical minefield of economic value versus universality of treatment (I made a similar comment on one of the blog’s questionnaires), but I will use myself as a case that shows the stupidity of this policy. I am a late 30s degree educated female with onset of symptoms and RRMS diagnosis within the past 20 months. I will *probably* be looking at increased disability over the next 15 years leading to a *probable* decrease in working hours and *possibly* unemployment as a result of this effing disease. I have been a higher-rate tax-payer for 15 years and if I did not have MS, I would expect my working life to continue for another 25-30 years as a higher- / highest-rate tax-payer. By withholding efficacious treatment, NICE is preventing me from being a contributor to society and making me a burden. To be perfectly frank, although my brain and CNS are apparently not very damaged and my ongoing symptoms are light in comparison with others, I am already tired of this disease and have plans to remove myself from this world when I have had enough (not imminently – despite this bout of depression I know there are currently far more positives than negatives in my life).I have education, a job, a comfortable life, wonderful friends and the most loving fiancé and family in the world, so if NICE’s decisions are making me feel like this now, I dread to think how I’ll be feeling in the years to come or how I would be feeling if I didn’t have the support I do.We all know that the NHS is under a burden impossible to have been foreseen by Bevan, but in the same month that the TaxPayers Alliance has identified £120 billion in government waste, the report that unlike every other G8 country we are the ONLY country paying the target rate of foreign aid and a report by a senior oncologist that a not insignificant number of foreigners are travelling to the UK for expensive NHS treatment (especially maternity, oncology, cardiology and renal care), I am absolutely livid that there is such a ban on treatment that might make my life easier.I was about to apologise for the self-indulgent rant, but if we can’t say it here, where can we say it? It is a vast understatement to say that I’m feeling somewhat frustrated at the moment.

    1. Not a self-indulgent rant at all, a very good post. Believe me, we share your frustrations and are doing everything in our power to change things.

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