Are the newer chemotherapy drugs worth their high cost? - A survey of UK public's perception of reasonable price for chemotherapy drugs according to their health benefit

Abstract

Background: The cost of oncology drugs has skyrocketed recently. Many newly approved drugs have modest survival benefits of only a few extra months. In USA, newer oncology drugs place a direct heavy economic burden on patients who make huge co-payments out of pocket (Saltz JCO 2015;33:1093-4). In UK the burden falls on the taxpayer. A face to face survey was done to assess UK public's perception of reasonable price for a course of chemotherapy drug relative to their potential benefits. Methods: A 'tick box' survey form with 15 price bands (low to high) including a free text box was used. (Price Bands: <0.5K, 0.5 to 1K, 1 to 2K, 2 to 5K, 5 to 10K, 10 to 20K, 20 to 30K, 30 to 40K, 40 to 60K, 60 to 80K, 80 to 100K, 100 to 250K, 250 to 500K, > 500K). Place of recruitment: (1) Market Town of Chesterfield: 20 recruited,56 declined (2) City of Nottingham 61 recruited, 23 declined. Recruitment period: March 2015. Survey done by Clinical research nurse or medical student on oncology elective. The regional ethics committee advised that a formal ethical approval is not needed for public surveys in public places. Results: Female 53%; Mean age 36 yrs (range 16 to 87 yrs). Subjects suggested a significantly lower value as a reasonable price for a course of cancer drugs even when drugs have significant curative potential. (table). Only a small minority felt that drug costs of more than 100,000 British pounds are reasonable . Because UK has a taxpayer funded health service, UK public probably have very poor knowledge about the actual cost of chemotherapy drugs. Conclusions: The survey results indicate that the UK public might be willing to politically support value-based-commissioning if it is done in a fair and explicit manner. (Table Presented).