Cancer Drug Money Back Guarantee?

Cancer Drug Money Back Guarantee?

December 6th, 2011 // 2:14 pm @

Last month, Roche began offering hospitals and insurers in Germany a money-back guarantee for its Avastin cancer med. Basically, the drugmaker will refund the cost – which can be anywhere from roughly $4,100 to $8,200 a month, depending upon the cancer being treated – if tumors continue to worsen within three to seven months.

The arrangement, which was reported by Bloomberg News, was prompted by a law passed last year in Germany that allows insurers to bargain over prices for new meds and comes as insurers, in general, try to link outcomes with reimbursement as health care costs continue to spiral.

This is actually not the first time such a deal has been reached. In 2007, Janssen Cilag agreed to a similar arrangement with the UK’s National Institute for Health and Clinical Excellence to refund the cost of Velcade for treating bone cancer multiple myeloma if results were unsatisfactory (see this and this). Some believe the notion of a money-back guarantee may catch on. “To bind (Avastin) to the performance of the drug is interesting,” Birgit Kulhoff, an analyst for Rahn & Bodmer, a bank in Zurich, tells the news service. “I would expect these kinds of deals more often.”

For Roche, such a deal, of course, offers a good deal of upside in the absence of a genetic marker that can indicate which patients would most benefit from Avastin, which is approved for treating lung, brain, kidney, and colon tumors. The drugmaker is under pressure since the FDA recently decided to remove an indication for breast cancer treatment after an extraordinary review (read here). As Bloomberg notes, worldwide Avastin sales fell 10 percent in the third quarter to $1.4 billion.

In the German contract, Roche has also agreed to reimburse the cost if patients take more than 10 grams of Avastin in a year, which is equivalent to about seven months of therapy for breast, kidney, and ovarian cancer patients because of the higher dosages such cancers require. “We’re aware of cost pressures in the public health-care system,” Grotzky says. “Access to our medicines is important to us.”

But not everyone is enamored of such arrangements. “What we need in health care is solid, proven evidence from clinical trials about what works,” Arthur Caplan of the Center for Bioethics at the University of Pennsylvania, tells the news service. “Not somebody running around with a rebate program, a guarantee, or a coupon.” In his view, this amounts to bad medicine.


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