Field of Science

Barry Werth on the cost of new drugs

Barry Werth who wrote the swashbuckling book about the creation of Vertex (sequel out in February) has an excellent piece (also highlighted by @Chemjobber) in the MIT Technology Review about the cost of new drugs. He asks a question which is usually the first question that any pharmaceutical scientist who tells a layperson what he/she does for a living encounters: Why do drugs cost so much? (The next question is usually "Why do drugs have so many side-effects?")

Werth compares two drugs to illustrate the strange world of drug pricing and the moral dilemma that riddles that world: Vertex's cystic fibrosis drug Kalydeco and Regeneron/Sanofi's cancer drug Zaltrap. Here's the problem: Kalydeco is a breakthrough medicine which has breathed completely new life into the treatment of a disease for which no effective therapies existed before. It costs about $300K a year. Zaltrap increases the median lifespan of patients with advanced colorectal cancer by 1.5 months. And it costs $11K a month. Now is it surprising why people are so critical of the pharmaceutical industry? I would be too, if I was constantly bombarded by news of "breakthroughs" like Zaltrap.

The reason why this whole thing seems so absurd is that the actual price of a drug often sounds almost completely arbitrary. As Werth notes, Zaltrap caused an outrage among patients and physicians, leading a group led by doctors from Memorial Sloan Kettering Hospital to protest the price of the drug in an unprecedented NYT Op-Ed. In response Sanofi cut the price of the drug by half through rebates and other schemes. If a drug company can reduce the price of a medication by 50% just like that without major catastrophe, it really makes you ask what the "true" price of the drug is.

In any case, the whole thing is definitely worth a read, especially in an age where drugs are paradoxically going to start becoming more effective - even as they are targeted toward select, small patient subpopulations - and simultaneously more expensive.

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