[Ip-health] Germany: The business with cancer

James Love james.love at keionline.org
Fri Apr 12 06:14:05 PDT 2019

Niklas Schenck pointed out this article, and I used Google translate to
read it.


February 24, 2019, 18:26

The business with cancer

Wolf-Dieter Ludwig, 67, oncologist, is Chairman of the Drug Commission of
the German Medical Association. (Photo: oh)

The industry is making big money with new drugs. The patients benefit too

By Wolf-Dieter Ludwig

The financial toxic effects of cancer drugs are currently being discussed
in many countries. In the US, personal bankruptcy is no longer uncommon as
a result of high co-payments in the treatment of cancer. In Germany,
high-priced drugs for cancer are increasingly endangering the sustainable
financing of our healthcare system.

For some years now, the drug market has seen a trend to develop about
one-third of newly approved drugs for the treatment of cancer. The reasons
are obvious: over the past decade, pharmaceutical companies have had to
make a strategic turnaround as patents expired for many of their sales
drivers, for example, for the treatment of high blood pressure and coronary
heart disease. They have therefore focused on lucrative market segments,
especially on cancer.

In particular, the novel immunotherapies have sparked Goldgräberstimmung at
the leading pharmaceutical companies. The latest sales figures for cancer
drugs show how successful the turnaround was accomplished: According to the
Drug Prescription Report 2018 were 6.5 billion euros from the public health
insurance in 2017 paid, worldwide there were (Source: IQVIA Institute)
around 133 billion dollars. The forecast for 2022: 200 billion dollars with
annual growth rates of ten to 13Percent. In particular, pharmaceutical
companies have benefited from major advances in basic academic research
that have contributed to a better understanding of carcinogenesis at the
molecular level and have enabled the development of many targeted drugs
with often new modes of action.

This is why cancer is currently by far the most lucrative market segment
for pharmaceutical companies - not only because of the high prices, but
also because of the demographic trend: there are more and more older
patients suffering from cancer who often lack curative therapy options.
Urgently needed medicines, for example for the treatment of diseases of the
central nervous system or antibiotics against infections with resistant
germs, were neglected on the other hand because of extensive research and
high development costs.

The Orphan Medicinal Products (Orphan Drugs) Regulations, which came into
force in the United States in 1983 and in Europe in 2000, were also a
godsend for the pharmaceutical companies, as the financial incentives -
seven to ten years of market exclusivity, reduced fees in the marketing
authorization process Cancer drugs could be used.

Unfortunately, the clinical benefit rarely justifies the high costs

Orphan drug sales worldwide are projected to grow to about $ 262 billion
annually by 2024, and 14 out of the top 20 drugs will be used to treat
cancers. Certainly, this trend is not in line with the original objective
of the European regulation: promoting the development of medicines at great
expense for low-demand clinical research. Unfortunately, new drugs for the
treatment of very rare, mostly congenital, genetically-related diseases
remain available for less than ten percent of these conditions.

Patients and physicians have high hopes for new medicines because many
cancer diseases, especially in advanced stages, lack effective treatment
options. The commonly used superlatives such as "breakthrough progress" or
"breakthrough in cancer medicine" are unfortunately rarely confirmed by
convincing clinical trial results. In addition, the clinical benefit
demonstrated during approval does not usually justify the exorbitant prices
for cancer drugs demanded by pharmaceutical companies today. The annual
cost of treatment for a patient often amounts to more than € 100,000 and
sometimes exceeds € 200,000 for combination therapies. Renowned health
scientists from the United States and the United Kingdom have recently been
able to show consistently that the majority of new anticancer drugs have
not been able to prolong survival and, if necessary, improve their quality
of life by an average of about three months.

Other than suggested by drug companies, the jump in the cost of therapy is
not explained by the high cost of research and development. Oncologists
from the United States in 2017 showed that the development costs of about $
650 million per drug, compared with revenues of $ 1,670 million.

It is high time to react to these aberrations. The explosive effect is
illustrated by an OECD report from 2018 titled "Pharmaceutical Innovation
and Access to Medicines". The situation in the pharmaceutical market and
the health economic problems, for example in cancer medicines and orphan
medicines, are described in detail. It is demanded that investments of
pharmaceutical companies should be more geared to the actual needs of
patients and less to the lucrative nature of applications, for example

Patients in low-income countries must have better access to assured
therapeutic progress. In order to improve the efficiency of expenditure in
the pharmaceutical market, competition should be encouraged, both between
patent medicinal products authorized for the same indication and for
medicinal products whose patents have expired and are available for
low-cost counterfeit medicines. Finally, there should be more transparency
in pricing, and the dialogue between all actors in the pharmaceutical
market should be improved. The goal must be to focus research and
development of pharmaceutical companies much more on social priorities than
in the past, and to enforce fair, value-for-money prices.

Monopolistic pricing for new cancer drugs with unsecured or low benefits,
which is always further from the cost of their development, is
unacceptable. It harms the individual patient and wastes social resources.

James Love.  Knowledge Ecology International
U.S. Mobile +1.202.361.3040
U.S. office phone +1.202.332.2670
http://www.keionline.org <http://www.keionline.org/donate.html>

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