Leaders in Pharmaceutical Business Intelligence (LPBI) Group

Curative Therapies: The Economics of Game Changing Science

Novel, potentially curative, cancer therapies are coming to market, with the promise to bring unprecedented benefits to patients. Recent experience in Hepatitis C therapy raises the question as to whether a new approach is now needed to design a pricing model that balances resulting cost pressure across the delivery system. While most constituents have recognized the cost effectiveness of curative therapies, they also present a challenge to payers in terms of the potential spike in patient volume and cost as these therapies are introduced. A broad ranging dialogue has emerged in the cancer community that includes discussions of cost effectiveness as part of the regulatory approval, shifting incentives for oncologists, increasing emphasis on early detection, integrating billing codes, bundled payments and management fees and many others.

The panel with top executives from the pharma, foundation, pharmacy and provider sectors will share insights on this crucially important topic.

• Cost of Cancer Therapy: single brand is a monopoly in the Past
• Rebates up to 50% on drugs: #13K for live extension, very effective quality adjusted drugs
• Value: If price go down quality
• Cancer drug – buy and bill,
• Cancer side: Pay more for a drug prolong 9 month vs 3 month, different types of Cancer – what do you do with value based??
• Drugs with lower thashhold
• BioSimilars in 2020 will lower prices
• do more with less

• Crowding space in the Immuno-therapy
• Immuno-oncology – antigens in conjugats
• chronic disease moves to cure
• Value, outcome of medicine bringing to populations
• minimize out of pocket expenses, CMS discussions to reimburse if no positive outcome — a drug is UNDER delivered no positive outcome
• Contracting with precision medicine will deliver outcome
• UK system vs US system: Access is different
• CMS – is the decision factor in healthcare
• Price and Value delivery is high active
• drug development is riskiest of all economic activities like throughing all the endowment on one drug, citing George Demitri, Dana Farber
• contract to demonstrate value: Cancer and CVD are different
• Contracts need be
• sequencing BRCA mutation 65% in the US, if mutation on board get the treatment, not if mutation is not there
• BioMarkers, fast
• Focus around the Patient: CMS — little consultation
• Access to testing: Lung Cancer vs Breast Cancer – share
• AZ and Lon longevity Craig Verter — THE FUTURE is in sequencing

• Sense for all the drugs
• Access to clinical trial and treatments
• disperities
• Right Therapy Cancer Vaccines, Immuno Therapies — what is right for the patient
• Device and Drugs – in Cancer vs CVD Drug eluting Stents — in oncology now — devices need to be developed as life saving therapies
• Private sector and Academia as a market need to come with solution better than Government=CMS
• today stents are biodegradable we reach that level of innovation because the thrombotic of bare stents did not remove them from market
• Payer and Providers to collaborate like in medical devices, will providers and Drug maker can collaborate???
• NEW building for basic science research, bench to clinic Neuro Science, Allergy, Cancer initiative is already existing

• 20% decrease in Cancer disease in last 10 years
• Insurance to cover Cancer to get access to quality
• value-based system  vs post treatment follow up and outcomes
• 2013 – $74.8 Billion investment in cancer care – continue innovations
• society can manage the cost: LIVE STYLE
• Improve affordability
• Right drug to right Patients

• Economic pressure at MGH – global payment, drugs push budget into repyment profile
• Providers – squeeze the treatment only to these that have value
• CMS – set Prices for MDs, Hospitals they need to negotiate Drug Prices
• ACA – increased population served, drug price increased, other costs stay the same
• Telemedicine: Cancer – target, immune-therapy using Telemedicine will replace visits by Patients
• Security for Patient information transmission
• Medical Oncology is the most exciting field of Medicine