The Use of “Added Benefit” To Determine the Price of New Anti-Cancer Drugs In France, 2004-2017, by Marc Rodwin

Marc Rodwin, holder of the Chair in Integrated Cancer Research, joined with the IPC from september 2017 to july 2018, has writen an article published in the European Journal of Cancer.

Marc Rodwin is professor of Law at Suffolk University Law School, and was IMéRA resident 2017-2018, holder of the Chair in Integrated Cancer Research, joined with the IPC. He was working onto the research project Reforming Pharmaceutical Policy & the Pharmaceutical Industry. He is the author of Conflicts of Interest and the Future of Medicine: The United States, France and Japan (Oxford, 2011); and Medicine, Money & Morals: Physicians’ Conflicts of Interest (Oxford, 1993).

The Use of “Added Benefit” To Determine the Price of New Anti-Cancer Drugs In France, 2004-2017

MA. Rodwin1, J Mancini2, S Duran3, AC Jalbert4, P Viens5, D Maraninchi6, A Gonçalves7, and P Marino8

European Journal of Cancer Volume 145, March 2021, Pages 11-18

1 Law School, Suffolk University, Boston, MA 02140 U.S.A; 2 Aix-Marseille Univ, APHM, INSERM, IRD, SESSTIM, Hop Timone, BioSTIC Marseille, France; 3 Institut Paoli Calmettes, Department of Clinical Research and Innovation, Marseille, France; 4  Hospital Center of Draguignan, Draguignan, France; 5 Institut Paoli-Calmettes, Aix-Marseille Univ, Marseille, France; 6 Institut Paoli-Calmettes, Department of Medical Oncology, Aix-Marseille Univ, Marseille, France; 7 Institut Paoli-Calmettes, Department of Medical Oncology, Aix-Marseille Univ, Inserm, CNRS, CRCM, Marseille, France; 8 Institut Paoli-Calmettes, SESSTIM UMR1252, Aix Marseille Univ, INSERM, IRD, Marseille, France.

Full text at: https://authors.elsevier.com/c/1cMEA_Lqip8WM8

ABSTRACT

Background 

Increasing drug prices strains budgets. Assessing the relation between added benefit and prices can help clinical decision-making and resource allocation. 

Methods

We assessed, over a period of 13 years, the relation between added therapeutic benefit and prices for drugs to treat solid tumors in France using the French High Authority of Health Scale (ASMR) and the European Society for Medical Oncology Magnitude of Clinical Benefit Scale (MCBS).

Results

36 medications were approved for 68 indications. There was a weak correlation between ASMR and MCBS scales (Spearman’s |ρ| = 0.28). Drugs had low added benefit on both ASMR (71%) and MCBS (49%) respectively.

Mean monthly price for new drugs was €4,616 (S.D., €3,096), ranging from €1,795 to €19,675 and increased by 47% comparing 2004-2012 to 2013-2017. The mean monthly price difference of new drugs over their comparator was €3,700 (S.D. €3,934) ranging between a €13,853 decrease and a €19,675 increase.

There was a weak but statistically significant correlation between ASMR and price (|ρ| = 0.35, p=0.004) and between MCBS and price (|ρ| = 0.33, p=0.005). Correlations between added benefit and prices were similar or higher for first indications (ASMR, |ρ| = 0.37, p=0.030; MCBS, |ρ| = 0.48, p=0.004).

In first indications, mean monthly prices increased €3,954 for drugs without ASMR added benefit. The mean annual price and price increase for first indications offering no ASMR benefit was €57,312 and €47,448 respectively. Conclusion: prices and benefit are weakly correlated. However, prices increased substantially even for drugs with no added benefit.

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