A Wall Street Journal article on March 13 reported that Bristol-Myers Squibb’s cancer drug Opdivo® has outperformed Merck’s similar drug, Keytrudo®, by falling back on an “old, mass-marketing approach.” Merck’s product is paired with a diagnostic test used to identify patients expressing the PD-L1 protein, in whom the drug would be the most effective. Merck’s trials only included patients expressing this protein, and the FDA approved the drug only in those who test positive for it.
The addition of cost as an evaluation criterion and the re-evaluation of drugs already on the CDF priority list has been a contentious topic within the oncology market access world. The pharmaceutical industry and cancer advocacy groups are fearful that cost will be the major factor in CDF decisions and will further restrict the number of treatment options that are available to patients. Others applaud the change, viewing it as preventing the use of overpriced drugs in the UK.
Are the manufacturers’ and cancer advocacy groups’ fears warranted? Does cost really outweigh the clinical efficacy of the drug in the CDF decision-making process?