ExpensiveNewDrugsAreTheyWorthIt.ppt

Expensive New Drugs:Are They Worth It?;Cancer treatment as aparticular area of concern;Copyright restrictions may apply.;Cost of treatment for metastatic colon cancer(Schrag D. NEJM. 2004;351:317-319);Reasons for increasing costs of cancer treatment;Pharmaceutical cost increasesalso raise concerns ;What drives increased spending on pharmaceuticals?;Is increased spending on drugs bad?;Can we afford these drugs?;QALYs;When is a treatment cost-effective?;Some sample QALYs (2002 dollars)Harvard Public Health Review (Fall 2004);Condition/Treatment ;The example of bevacizumab;Phase III trial of bevacizumab in metastatic colon cancer;Examining the cost and cost-effectiveness of adding bevacizumab to chemo in metastatic colon cancer;Randomized trial compared chemotherapy alone vs. chemotherapy + bevacizumab Bevacizumab regimen prolonged median survival from 10.2 to 12.5 months (p=0.007) Cost of extra 2.3 months? $66,270-$80,343 $345,762 per year of life gained (assuming $66,270 cost) Grusenmeyer PA, Gralla RJ. J. Clin. Oncology. 2006;24(18S):6057. ;Do oncologists believe bevacizumab offers good value? ;Do patients believe bevacizumab offers good value?;Is it cost-effective to add erlotinib to gemcitabine in advanced pancreatic cancer?;Cost-effectiveness analysis of trastuzumab in the adjuvant setting for treatment of HER2+ breast cancer;Expensive new drugs and the poor; Growth in Medicaid spending (Medicaid expenditures as percentageof total state spending);Medicaid expenditures ($ billions) for outpatient prescription drugs;Expensive new drugs and the poor;Impact of 2010 health care legislation;Need to reduce over-prescribing;QALYs