Out of Pocket Costs for Follow-Up Tests After Abnormal Screening Mammogram and Their Impact on Breast Cancer Survival

Today, the American Cancer Society’s Cancer Action Network released a report titled “Out of Pocket Costs for Follow-Up Tests After Abnormal Screening Mammogram and Their Impact on Breast Cancer Survival.” The empirical analysis was conducted by myself and some colleagues at FTI Consulting (Shanshan Wang, Shurui Zhang, Citseko Staples Miller, and Sophia Mildred Setterberg). An…

What is ‘Bayesian Hierarchical Modelling’ and how can it be used to evaluate oncology treatments studied in basket trials?

Should payers cover a new oncology treatment targeting specific biomarkers across multiple tumor types? One the one hand, one could require a separate trial for each tumor type. While this would be convincing evidence, it also is very expensive to conduct clinical trials for every tumor type, particularly if treatment efficacy is homogenous across tumor…

Do first-in-class cancer drugs receive a pricing premium?

According to a paper by Miljković et al. (2023), the answer is ‘no‘. The authors examine oncology treatments with FDA approvals between 2015 and 2020 and identify average wholesale prices from Redbook. Drugs were classified into three categories: (i) first approval of a new mechanism of action compound, (ii) next-in-class approval regardless the tumor type,…

The cancer tax

An ambitious paper by Chen et al. (2023) published last week aim to estimate the economic burden of cancer across 204 countries between 2020 and 2050 . The authors find that cancer’s economic burden is equivalent to an annual tax of 0.55% of global GDP. The full results are below. The estimated global economic cost…

Single Arm Trials for FDA Drug Approvals in Oncology

These are becoming increasingly common. Agrawal et al. (2022) use data between 2002-2021, and found that FDA approved: …176 new malignant hematology and oncology indications based on single-arm trials, including 116 accelerated approvals (AAs) and 60 traditional approvals. Overall, 87 approvals (49%) were for new molecular entities or original biologics and 89 (51%) were supplemental…