A cancer patient hugs his wife Mercy Fore River Campus in Portland, Maine

A cancer patient hugs his wife Mercy Fore River Campus in Portland, Maine on December 6, 2017.

(Photo: Derek Davis/Getty Images)

Report Shows How Big Pharma Is Price Gouging Cancer Patients

"Cancer patients—the majority of whom are on Medicare—can face annual out-of-pocket costs of more than $16,500."

Major pharmaceutical companies are profiting immensely from the second-leading cause of death in the United States by saddling cancer patients with tens of thousands of dollars in out-of-pocket costs, often forcing them to choose between treatment and other basic necessities.

But many people living with cancer in the U.S. will soon see long-overdue relief thanks to provisions of the Inflation Reduction Act (IRA), a law that the pharmaceutical industry lobbied aggressively against and is still fighting tooth and nail.

According to a report published Wednesday by Patients for Affordable Drugs, cancer patients will benefit substantially from the IRA's $2,000 cap on annual out-of-pocket medicine spending for Medicare Part D enrollees—a limit that's set to take effect in 2025.

Of the nearly 62,000 people on traditional Medicare who receive a brand-name cancer drug through Medicare Part D, 99% will see savings from the out-of-pocket spending cap, said Patients for Affordable Drugs, which partnered with the National Opinion Research Center (NORC) at the University of Chicago on the new analysis.

On average, that population will see savings of more than $7,500 once the spending cap is in place in 2025. Some will see savings of over $19,000 in 2025.

"To afford it, I have fundraised, searched for grants, sold furniture and my husband's truck, and zeroed out our savings."

The coming savings highlight the extent to which cancer patients and the Medicare program are currently being gouged by cancer drug manufacturers, which often raise prices on their products annually after developing them with government support.

"Between 2017 and 2021, the average initial price of a new Part D cancer drug rose by more than 25% to over $235,000 yearly when adjusted for inflation," Patients for Affordable Drugs noted in its new report, citing a recent investigation by Rep. Katie Porter's (D-Calif.) office. "Pharmaceutical companies then raise the prices on these drugs year after year."

David Mitchell, the founder of Patients for Affordable Drugs and a blood cancer patient whose medications come with a list price of more than $900,000 a year, said in a statement Wednesday that "cancer patients—the majority of whom are on Medicare—can face annual out-of-pocket costs of more than $16,500."

"The historic Inflation Reduction Act includes policies that will bring needed relief to millions of patients, especially older Americans with cancer," said Mitchell. "We've been waiting for this relief for far too long."

The new report spotlights several high-priced brand-name cancer medications sold by Pfizer, Bristol Myers Squibb (BMS), Johnson & Johnson, and other major pharmaceutical companies.

Pfizer has hiked the price of Ibrance, a breast cancer medication, every year since it came to market in 2015. Today, the list price is "more than $15,000 per bottle," Patients for Affordable Drugs observed.

"Celgene/BMS has almost tripled the price of Revlimid—a drug to treat multiple myeloma—since it came to market in 2006," the group added. "Despite being on the market for more than 15 years, the drug remains one of the best-selling products in the world. Much of these sales are paid for by taxpayers, with Medicare Part D spending over $5.8 billion on the drug in 2021 for 45,601 beneficiaries."

Jackie Trapp, a multiple myeloma patient in Wisconsin, told Patients for Affordable Drugs that Revlimid costs her "$20,000 each year on Medicare."

"To afford it, I have fundraised, searched for grants, sold furniture and my husband's truck, and zeroed out our savings," she said. "The price of Revlimid has had real impacts on my husband and my quality of life. It is already unfair that I am likely to leave my husband all alone sooner than I would like, but now I fear of leaving him bankrupt as well."

Trapp's case is hardly an outlier.

A recent American Cancer Society Cancer Action Network survey of 1,218 cancer patients and survivors found that "more than 70% of respondents said they made significant lifestyle changes in order to afford care, including delaying major purchases (36%), depleting most or all of their savings (28%), going into more credit card debt (28%), and borrowing money from relatives and friends (20%)."

Trapp said the $2,000 out-of-pocket spending cap "will be huge," helping "bring me and my husband peace of mind, knowing that my portion of my sky-high drug prices will be lower than it is now and that we'd have a reasonable limit if I lost my grant."

The new report comes as the Biden administration is facing pressure to build on the Inflation Reduction Act, which will also require Medicare to negotiate the prices of a small number of high-cost prescription drugs.

Merck, whose cancer drug Keytruda carries an annual list price of $175,000, sued the Biden administration last week in an attempt to block the price negotiation provision.

Patients for Affordable Drugs pointed out that Keytruda and Revlimid are in the top ten drugs for U.S. sales in 2021 and their manufacturers have applied for more than 180 patents on each drug."

"Research shows that when drug corporations amass dozens of patents, competition from lower-priced generics and biosimilars is delayed, leaving patients and taxpayers footing the bill for billions in unjust profits," the group said. "Fortunately, there are bills in the 118th Congress that crack down on abuse of the patent and regulatory system. If these bills become law, they will enable more affordable drugs to come to market more quickly, providing relief for patients struggling to pay for overpriced medications."

Rep. Pramila Jayapal (D-Wash.) and Sen. Elizabeth Warren (D-Mass.) have also outlined steps the United States Patent and Trademark Office can take immediately and unilaterally to curb abuses of the patent system.

"For decades," the lawmakers wrote in April, "powerful pharmaceutical companies and other large corporate actors have repeatedly abused the patent system to stifle competition and prolong their market power, showing no regard for the harm done to patients through sustained high prices."

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