Using "mean survival gain" instead of "median survival gain" is a more accurate way to calculate the value of cancer drugs, two professors of health policy and economics at Los Angeles-based University of Southern California wrote in an opinion article published by STAT.
Median survival gain is currently the metric most often used to determine the value of new cancer drugs. It reveals the gain in survival from a new drug therapy at the point in a clinical trial where half the participants have died. Mean survival gain considers the survival of all the patients in a sample, including the people who survive after half the group has died.
Alice Chen, PhD, and Dana Goldman, PhD, argue that, though the median survival rate is a more convenient measure, since the trial can be discontinued once half the patients have died, it is blind to the survival gains of the remaining patients. Research has shown that patients care more about long-term cures than median survival, they argue.
From 1995 to 2017, new cancer drugs increased the median survival gains by an average of about six months and the mean survival gains by almost a full year. During that time, the cost of cancer drugs rose faster than median survival gains, but not faster than mean survival gains, according to the authors.
Dr. Chen and Dr. Goldman argued that if cancer drug prices were adjusted the same way as the prices of housing or computers, we wouldn't see any increase at all.
"Striking a balance between affordability and future innovation will require policies that, among other considerations, accurately relate a drug’s price to its total value. We need to take into account the mountaintop view, not just the price per square foot," the authors concluded.
Dr. Goldman holds equity in Precision Health Economics, a consultancy to life sciences companies, some of which produce cancer drugs.
Read the full article here.