Prices for a cancer drug called lomustine have skyrocketed nearly 1,400 percent since 2013, putting a potentially life-saving treatment out of reach for patients suffering from brain tumors and Hodgkin's lymphoma. Though the 40-year-old medication is no longer protected by patents, no generic version is available.
According to the Wall Street Journal, lomustine was sold by Bristol-Myers Squib for years under the brand name CeeNU at a price of about $50 a capsule for the highest dose. The drugmaker sold lomustine in 2013 to a little-known Miami startup called NextSource, which proceeded to hike lomustine's price nine times since. It now charges about $768 per pill for the medication.
According to an analysis done for the Journal by Truveen Health Analytics and Elsevier, NextSource this year raised prices for the drug, which it rebranded as Gleostine, by 12 percent in November following a 20 percent increase in August.
NextSource CEO Robert DiCrisci, told the Journal that the company sets its prices based on the costs it incurred in developing the medication and the benefits it provides patients. Like other drugmakers, the company provides discounts and financial assistance to those who can't afford its cost. A spokesperson for NextSource didn't respond to an email requesting comment for this story.
Henry S. Friedman, a professor of neurosurgery at Duke University School of Medicine, accused NextSource of "price-gouging" in an interview with the Journal, adding: "People are not going to be able to afford it, or they're going to pay a lot of money and have financial liability."
According to the Journal, the U.S. Food and Drug Administration is offering to expedite the regulatory review process for more than 300 drugs like lomustine that lack generic competitors although their patents have expired, part of the Trump administration's overall effort to lower pharmaceutical prices. Whether there is enough demand for a niche product like lomustine is hard to say, however.
“Nobody should be profiting excessively from somebody's health," said Dr. Drew Silverman, a doctor of Pharmacy at Tampa General Hospital. Dr. Silverman went on to say that some brain cancer patients who have tried other drugs unsuccessfully may be stuck with lomustine.
“If they're already to the point where they've failed other therapies and they need this drug and they're dealing with fighting with their insurance company to get it paid for, they may lose their window," said Dr. Silverman.
“A lot of insurance companies and pharmaceutical companies will argue about their responsibility to their shareholders before they talk about their responsibility to their patients," he added. "I think that's a problem. So I think that the government, sadly, has to be the ones to come up with a solution where there's an intermediate level where you can make your profit but not jeopardize the health of the American population.”
Soaring prices for cancer drugs are a concern for both patients and doctors because financial pressures can lead to delays in seeking treatment that can easily surpass six figures per year. A study published earlier this year in the Journal of Clinical Oncology found prices for 24 patented injectible Medicare Part B drugs rose an average of 18 percent annually over the past eight years on an inflation-adjusted basis. Prices continued to rise even when generic versions of the drug became available.
Patients with cancer are among the most likely to feel the pain of recent drug price hikes. Novartis (NVS), the Swiss drugmaker, is charging $475,000 per patient for its Kymriah treatment for certain types of blood cancers. Another blood cancer medication developed by Gilead Sciences (GILD) called Yescarta costs $373,000. (According to Bloomberg News, patients have experienced delays in getting the breakthrough treatment because of payment delays by both private insurers and Medicare and Medicaid.) The brain tumor treatment called Alecensa is priced at nearly $160,000 a year.