The rising cost of anti-cancer drugs in Australia — ASN Events

The rising cost of anti-cancer drugs in Australia (#143)

Deme Karikios 1 , Deborah Schofield 1 , Glenn Salkeld 2 , Kristy Mann 1 , Judith Trotman 3 , Martin Stockler 1 3 4
  1. NHMRC Clinical Trials Centre, University of Sydney, Sydney, NSW , Australia
  2. Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia
  3. Concord Cancer Centre, Concord Repatriation General Hospital, Sydney, NSW, Australia
  4. Sydney Cancer Centre, Royal Prince Alfred Hospital, Sydney, NSW, Australia

Objectives: To determine changes in the cost of anti-cancer drugs to the Australian Pharmaceutical Benefits Scheme (PBS) from 2000 to 2012, and to consider the reasons and implications.

Design and setting: Review of the Australian Pharmaceutical Benefits Scheme (PBS) expenditure and prescription reports, Pharmaceutical Benefits Pricing Authority (PBPA) annual reports and Schedule of Pharmaceutical Benefits from 2000 to 2012.

Main outcome measures: Total annual PBS expenditure on anti-cancer drugs, average price paid by the PBS per anti-cancer drug prescription and estimated monthly price paid by the PBS for newly listed anti-cancer drugs.

Results: The annual cost to the PBS of anti-cancer drugs rose from $65 million in 1999-2000 to $466 million in 2011-2012, representing a 19.1% average annual increase.  Total PBS expenditure, excluding anti-cancer drugs, has increased on average by 9.0% annually over the same time period.  The average price paid by the PBS per anti-cancer drug prescription increased by 133% in real terms from $338 in 1999-2000 to $786 in 2011-2012 (adjusted to 2012 prices). The real average annual increase in the price per prescription from 2000 to 2012 was 7.6%. In comparison average prices paid per prescription for treatment of other high burden diseases such as drugs used in diabetes, lipid-modifying drugs, and psychoanaleptics have had a real annual average increase of 1.6% and decrease of 2.4% and 2.0% respectively. The estimated median price for a month’s treatment of the 23 newly listed anti-cancer drugs during the study period was $4919 (2012 prices). Prices for individual drugs ranged from $1003 to $12578 per month.

Conclusions: Dealing with the burgeoning costs of anti-cancer drugs at a societal and individual level while retaining effective, equitable and readily accessible cancer care, is and will, continue to pose a significant challenge for our health system.