Nieuwe dure geneesmiddelen tegen kanker; een dilemma

The number of new cancer patients in the Netherlands is increasing annually: there were approximately 100,000 new cases in 2010 and there will be more than 120,000 in 2020. The number of systemic therapies available for these patients is growing rapidly, and spending on anticancer drug doubled within ten years, to EUR 733 m in 2013. During the past few years the amount spent on new targeted drugs was compensated by the expiration of patents for frequently used cytostatics such as paclitaxel, docetaxel, gemcitabin, oxaliplatin and irinotecan. Immunotherapy is now available for patients with metastatic melanoma and the new ‘checkpoint inhibitors’ look promising for other cancers, including lung cancer, renal cell cancer, and bladder cancer. These drugs, as well as the numerous new targeted agents, are very expensive. The price for 4 cycles of ipilimumab for a patient with metastatic melanoma is approximately EUR 80,000. A special committee of the Dutch Cancer Society (KWF) released a report on the increasing costs of anticancer treatments and gave recommendations concerning how to address this issue. First of all, cost savings have to be achieved by lowering the price of the innovative drugs. The search for companion diagnostics should be encouraged, in order to avoid unnecessary drug administration. And, if these measures are not sufficient, the government should consider determining a price-ceiling for these treatments. A differentiation between treatments with curative intention or long-term survival benefits and those which only have marginal effects, would appear to be logical.

Conflict of interest: none declared. Financial support: none declared.