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Most Affordable Medications to Fight Cancer

cartoon boxing glove punching cancer cell

In the past couple of decades, new cancer drugs have transformed cancer treatment and cancer care, allowing many patients to be cured and many others to achieve long-term remission, even in those with previously untreatable cancers. Yet, despite a growing list of newly approved cancer drugs, cancer drug prices can make the treatment financially crippling for many families. 

Please continue reading to learn more about the health care costs that patients with a cancer diagnosis face and some options for affordable cancer medicines. 

What medications are used to treat cancer?

Some of the medication classes used for cancer treatments include:

  • Chemotherapy drugs kill cancer cells.
  • Immunotherapy or biological therapy drugs boost the body’s immune system to fight cancer. 
  • Hormone therapy drugs block the effects of hormones; they are used to treat breast cancer and prostate cancer. 
  • Targeted drug therapy acts on specific genes or proteins that cancer cells need to survive.

What are some alternatives to chemotherapy to kill cancer cells?

Besides chemotherapy and the other types of cancer drugs described above, cancer specialists (oncologists) can use other treatment options for both early-stage and advanced cancer, such as:

  • Surgery to remove the cancer.
  • Radiation therapy  to kill or slow down the growth of cancerous cells using high doses of radiation. 
  • Bone marrow transplant or stem cell transplant to place a donor’s healthy cells in a cancer patient’s bone marrow where they grow and make more healthy blood cells.
  • Tumor ablation such as cryoablation (using extreme cold) or radiofrequency ablation (using heat) to destroy cancerous cells.

How much does cancer medicine cost?

Cancer care in the United States is one of the most costly globally, and some of the world’s most expensive cancer drugs are sold here. In the last couple of decades, there has been a sharp increase in the price of cancer care, especially the cost of new cancer drugs launched on the market for the first time. According to the National Cancer Institute, cancer drug prices have reached the $400,000 price tag for a year of treatment. 

Here are some indicative prices for a few new drugs recently approved by the U.S. Food and Drug Administration (FDA):

  • The immunotherapy agent atezolizumab (Tecentriq) was approved to treat lung cancer, bladder cancer, and liver cancer. It costs nearly $14,000 a month.
  • A combination of Tecentriq (atezolizumab) and Abraxane (nab-paclitaxel) was approved for advanced breast cancer. Tecentriq costs over $13,000 a month, and the retail price of Abraxane is around $10,000.
  • The targeted drug encorafenib (Braftovi), used in combination with cetuximab, for certain types of metastatic colorectal cancer, costs nearly $14,000 for a supply of 120 capsules Braftovi alone.
  • Targeted therapy with erdafitinib (Balversa) for bladder cancer costs anywhere from $10,000 to $22,000 for a month’s supply.
  • Polatuzumab vedotin-piiq (Polivy) was approved in 2019 by the FDA to treat a type of non-Hodgkin lymphoma and costs $90,000 for a four-month course.
  • Yescarta, immunotherapy used for the treatment of non-Hodgkin lymphoma, costs $373,000 for one dose.
  • Kymriah, a gene therapy used to treat acute lymphoblastic leukemia, one of the most common blood cancers in children, costs $475,000 for one treatment course.

Given these mind-boggling drug prices, it is no surprise that cancer care in the U.S. is unaffordable for the majority of cancer patients. Many patients face financial distress, lose their jobs, their homes, and leave behind a legacy of enormous debts for their families after their deaths. What’s more, the high prices of cancer drugs do not come with any guarantees of cure or remission. Indeed, health care providers warn that many of these treatments, unfortunately, come with severe and even fatal side effects.

Why are cancer drugs so expensive?

Cancer treatments in the U.S. cost far more than in other countries due to several factors. The U.S. is at the forefront of new drug development. Pharmaceutical companies spend a lot of money on drug development costs and clinical trials required to get regulatory approvals for cancer drugs

Another reason for high drug pricing is that many cancers are incurable, requiring patients to undergo multiple treatment cycles and modalities. The use of one drug does not automatically mean that other approved cancer drugs will not be needed in the future. Meaning, if the first treatment fails, the patient moves on to a different cancer drug or treatment, adding to the overall cost of cancer care. 

Also, due to the serious prognosis of most cancers, health care providers are often willing to prescribe new cancer drugs and patients are willing to try them, despite the high cost of cancer therapy and the possibility of marginal improvements in overall survival. 

What are biologics and biosimilars for cancer treatment?

One of the ways to lower the cost of cancer therapy for patients is the use of biosimilars. These are versions of known and proven biologic drugs that work to treat cancer by stimulating the immune system, finding cancer cells, and attacking them. 

Biosimilars can be potentially cheaper than the reference drugs they are based on. Notably, the biologics (the reference drugs) have been researched, evaluated for safety and efficacy through clinical trials, and have received FDA approval. 

A biosimilar works similarly to its reference drug, somewhat like the generic version of a brand-name medication. However, unlike a generic drug that has the same active ingredient as a brand-name drug, a biosimilar and its reference drug are not exactly the same. 

The pharmaceutical industry can offer biosimilars at lower prices because the reference drug has already gone through the expensive development and approval process. This gives patients a lower-priced option for a cancer drug that delivers similar clinical benefits. 

However, coverage for similar drugs (biosimilars) can vary between insurance providers like Medicare, Medicaid, and private insurance companies. 

What are some relatively affordable cancer drugs?

Examples of some potentially lower-priced biosimilars approved by the U.S. FDA include: 

  • Reference drug filgrastim (Neupogen)  biosimilars: filgrastim-sndz (Zarxio) and filgrastim-aafi (Nivestym), which stimulate the growth of the white blood cells. 
  • Reference drug bevacizumab (Avastin) biosimilars: bevacizumab-awwb (Mvasi) and bevacizumab-bvzr (Zirabev), used to treat colorectal, brain, lung, kidney, and cervical cancers. 
  • Reference drug trastuzumab (Herceptin)  biosimilars: trastuzumab-dkst (Ogivri), trastuzumab-pkrb (Herzuma), trastuzumab-anns (Kanjinti), trastuzumab-qyyp (Trazimera), and trastuzumab-dttb (Ontruzant), used to treat certain breast and stomach cancers. 
  • Reference drug pegfilgrastim (Neulasta)  biosimilars: pegfilgrastim-jmdb (Fulphila), pegfilgrastim-bmez (Ziextenzo), and pegfilgrastim-cbqv (Udenyca), used to help fight infection by preventing neutropenia in patients receiving cancer treatments.
  • Reference drug rituximab (Rituxan)  biosimilars: rituximab-abbs (Truxima) and rituximab-pvvr (Ruxience), used to treat non-Hodgkin lymphoma. 

What costs should cancer patients discuss with their healthcare team?

It is important for cancer patients and their families to have conversations about the costs of cancer treatments with their doctors and other members of the care team such as social workers, patient coordinators, and financial counselors. There are both direct and indirect costs involved in cancer patient care in the U.S health care system. Cancer drug prices are just the tip of the iceberg. 

While many serious questions need to be asked of drug companies about the cost of cancer therapy, in the meantime, the use of a biosimilar cancer drug might provide a relatively lower-cost alternative. Patients struggling to cope with high cancer drug prices should discuss the use of biosimilars with their medical oncologist and clinical oncology team, considering that coverage and reimbursement for any cancer medicines will depend on the health insurance provider. Also, keep in mind that social workers and financial counselors may have valuable resources regarding financial assistance. Therefore, it is worthwhile for patients and their families to meet with them to discuss and explore different options for aids prior to cancer treatment. 


References:

  1. https://www.cancer.gov/news-events/cancer-currents-blog/2018/presidents-cancer-panel-drug-prices
  2. https://amp.wbur.org/news/2018/01/11/cancer-drug-costs
  3. https://www.mayoclinic.org/tests-procedures/cancer-treatment/about/pac-20393344
  4. https://www.cancer.net/blog/2020-09/what-are-biosimilars-cancer-treatment
  5. https://ascopubs.org/doi/full/10.1200/OP.21.00771
  6. https://www.cancer.org/latest-news/2019-in-review-new-cancer-drug-approvals.html