NBCC urges Congress and the Administration to support initiatives that address systemic deficiencies in law, regulation, and science policy that result in the approval of drugs that do not significantly extend or save lives and whose prices are not based on value or effectiveness.
The cost of breast cancer care continues to rise. Overall, the national cost of cancer care overall in 2015 was $183 billion, with a minimum projected increase of 34 percent to $246 billion by 2030 based solely on the aging and growth of the U.S. population.1 This increase does not include anticipated increases in national costs for medical services and prescription drugs, which are predicted to increase during this period by 34 percent and 40 percent, respectively.
Despite the increasing cost of prescription drugs, most approved breast cancer drugs have not been shown to extend life. Federal agencies spent $243 billion in 2018 on medical and health research and development, much of it on competitive grants given for early-stage research. Findings from federally funded research are the basis for the product development work done by private pharmaceutical companies. U.S. tax dollars, allocated through NIH grants, were used to discover every pharmaceutical product approved by the FDA from 2000 to 2016. In addition to funding scientific findings via grants, the federal government encourages drug development by providing tax incentives. Drugmakers may write off some of the amount they spend each year on research and development using one or a combination of tax incentives.
As patients, we contribute to research by participating in clinical trials, lobbying for research funding, and paying taxes to support it. Our goal is to bring about drugs that will save lives. The research results are often patented, then sold to industry for millions of dollar —the individual doctor and the institution benefit and the companies that manufacture the drugs. But in breast cancer, these drugs rarely extend life and cost so much that they often bankrupt patients and the healthcare system.
Countries like Britain and Germany have taken extensive steps to introduce cost-effectiveness assessments into their healthcare systems, refusing to pay higher prices for new drugs that do not improve treatment effectiveness over existing options. U.S. taxpayers contribute through public university research, grants, subsidies, and other incentives. This means people are often paying twice for their medicines: through their tax dollars and at the pharmacy. It should be unacceptable for taxpayers to find a new medication that the public can’t even afford to buy once it hits the market.
Recent reports show that conflicts abound in the research system that currently exists. Moreover, due to the focus on financial gain, patients and the public have lost trust in this system. Passage of legislation to address systemic deficiencies in law, regulation, and science policy that result in the approval of drugs that do not significantly extend or save lives and whose prices are not based on value or effectiveness.
