Cost of cancer treatment rises by 25 per cent in five years

•Global oncology spending reached $100b in 2014 from $7b in 2009
•Breast tumour vaccines may work better with silicon micro particles 

A not cheery disclosure has come that the cost of cancer treatment globally has reached a record high from $75 billion in 2009 to $100 billion in 2014, which represents a 25 per cent increase in five years.

A new IMS report published yesterday in Medical News Today finds that early cancer diagnosis; treatment duration and effectiveness of therapies have improved alongside increased levels of spending on cancer drugs.

According to the IMS report, the global spending on oncology medicines broke the $100 billion threshold in 2014. IMS Health is a leading global information and technology services company providing clients in the healthcare industry with comprehensive solutions to measure and improve their performance.

A source at the Cancer Treatment Centre at Lagos University Teaching Hospital (LUTH) Idi Araba told The Guardian that an average cancer patient, on regular screening, clinical assessment and chemotherapy, over the course of a year, may accumulate N5 million to N20 million or more in medical bills depending on the type of cancer, the type of treatment and where the treatment is being accessed.

The Guardian also reliably gathered that cost of cancer treatment in LUTH is one of the cheapest in the country because the Federal Government has subsidized it.

It was further revealed that Nigeria has no comprehensive cancer centre, and lacks adequate treatment facilities hence citizens are compelled to spend over $200 million annually on treatment abroad, often in India which has over 120 cancer centres, mostly established through non-governmental effort, with private sector support.

Thousands of patients usually travel abroad for treatment at the end stage and return home as corpses. Also, the effectiveness of cancer vaccines could be dramatically boosted by first loading the cancer antigens into silicon micro particles.

The report was published in Cell Reports. Model studies showed that micro particles loaded with an antigen, HER2, not only protected the antigen from premature destruction, but also stimulated the immune system to recognize and relentlessly attack cancer cells overexpressing the HER2 antigen.

Meanwhile, IMS Health senior vice president and executive director of the IMS Institute for Healthcare Informatics, Murray Aitken, who produced the new report said: “the increased prevalence of most cancers, earlier treatment initiation, new medicines and improved outcomes are all contributing to the greater demand for oncology therapeutics around the world.”

One of the report’s key findings is that the cost of the global oncology market reached $100 billion in 2014 – an increase of $75 billion from 2009.

However, within the United States (US), there has only been a modest increase of spending compared with the five largest European countries. Between 2010 and 2014, oncology grew from 13.3 per cent of total drug spending to 14.7 per cent in those European countries, compared with a rise from 10.7 per cent of total drug spending to 11.3 per cent in the U.S during the same period.

Another main finding is that clinical outcomes are improving for all major cancers. According to the report, five-year survival rates have risen thanks to continuous improvements in detection and treatment.

Two thirds of Americans diagnosed with cancer live for at least five years nowadays, compared with just over half in 1990. The report predicts that these increases in survival will continue substantially thanks to new developments in “immuno-oncologic” and combination treatments, and suggests that biomarker-driven drugs and diagnostics will have a transformative effect on oncology.

Aitken said: “Innovative therapeutic classes, combination therapies and the use of biomarkers will change the landscape over the next several years, holding out the promise of substantial improvements in survival with lower toxicity for cancer patients.”

The report found that patient access to cancer drugs varies wildly across all markets, however, in 2014, patients in Japan, Spain and South Korea had access to fewer than half of the new cancer drugs launched globally in the past five years.

Even in the wealthiest countries, drugs that are not reimbursed will only reach a tiny proportion of patients. In the U.S, average treatment costs per month have increased by 39 per cent over the past 10 years.

In the same period there has also been improvements in patient response (about 42 per cent) and treatment duration (increase of 45 per cent), which the report states reflect improved survival rates.

The report also observed that the costs of intravenous cancer drugs in the U.S skyrocketed by 71 per cent during 2012-13 as a result of increased outpatient facility costs.

Finally, the IMS reveal that discussion boards, followed by Twitter, have become the most dominant channels that patients use to engage with a variety of topics – from treatment options to financial concerns – during their cancer journey.

The researchers assessed six months of social media discussions related to prostate cancer and found that the most frequently discussed topic was treatment options, followed by financial concerns.

A recent analysis published in Blood, the Journal of the American Society of Hematology, found that new, expensive blood cancer drugs – which can cost up to $100,000 per year – deliver high-value treatment.

Senior author of that study and director of the Center for Evaluation of Value and Risk in Health at Tufts Medical Center in Boston, MA, Peter S. Neumann, said: “given the increased discussion about the high cost of these treatments, we were somewhat surprised to discover that their cost-effectiveness ratios were lower than expected.

“Our analysis had a small sample size and included both industry- and non-industry-funded studies. In addition, cost-effectiveness ratios may have changed over time as associated costs or benefits have changed.” Neumann added: “The study underscores that debates in health care should consider the value of breakthrough drugs and not just costs.”

Principal investigator of the study published in Cell Reports, Dr. Haifa Shen, said: “We could completely inhibit tumor growth after just one dose of the cancer vaccine in the animal model.

This is the most amazing result we have ever seen in a tumor treatment study.” The success of the treatment, Shen and his team learned, appears to be the porous silicon micro particles (PSMs) themselves.

In vivo and in vitro studies confirmed the micro particles stimulated a strong, sustained innate immune response at local sites of tumor activity and growth — with or without any antigen loaded. Shen said: “We have shown for the first time that a micro particle can serve as a carrier for sustained release and processing of tumor antigens.

“But just as importantly, we learned the micro particles themselves appear to be enough to stimulate a type I interferon response, and were even transferred from one antigen-presenting cell to another to maintain a long-lasting antigen-releasing effect.”

Cancer vaccines are designed to turn a patient’s own immune system more strongly against cancer cells, and have been an area of recent and intense interest among oncologists.

Since 2010, the United States Food and Drug Administration (FDA) has approved vaccines and other immunotherapy drugs for melanoma, prostate cancer, and lung cancer. There are currently dozens of active clinical trials evaluating vaccines for cancer therapy.