MANAGED CARE June 2011. ©MediMedia USA
Expensive new drugs could drive spending in the cancer drug category by as much as 15 percent a year through 2013, according to a Medco report. That rate would place the category just behind diabetes and central nervous system treatments by 2015, according to the company’s Drug Trend Report, which tracks utilization and spending.
“New cancer drugs reaching the market are expected to double during the next several years,” says Glen Stettin, MD, Medco’s chief medical officer. With these advances, the number of U.S. cancer survivors is expected to increase by more than 30 percent — from 13.8 million people in 2010 to 18 million people a decade later.
The heightened demand for oncology drugs has fueled specialty pharmacy demand as well. The report says that interest in these specific, targeted oncologic therapies have resulted in the price of oncology drugs surging 11.5 percent during 2010. And because many of the newer treatments are oral medications or can be self-administered, the dynamics of cancer delivery are changing, with home administration growing in importance compared with the physician’s office or an infusion center.
“It’s an exciting time in the area of cancer treatment, but as these new, targeted treatments come to market, it is vital to ensure that each patient and caregiver understand the importance of adherence and the associated detailed dosing instructions,” says Milayna Subar, MD, a national practice leader in Medco’s Oncology Therapeutic Resource Center. Overall, cancer drugs constitute 47 percent of the specialty drug pipeline, with about 125 drugs in phase 3 clinical development for cancer, 38 of which are oral medications.
The report notes that cancer treatment costs under the medical benefit, rather than the pharmacy benefit, can be substantial. But many of the medication costs are “hidden” under the medical benefit and may not be as apparent to health plans and insurers as areas of drug therapy that are paid under the pharmacy benefit. However, with about 35 to 40 percent of cancer drugs in the pipeline being oral or subcutaneously administered, and with increasing emphasis on medical management, more oncology costs are likely to move under the pharmacy benefit.