A report published February 5 in the New England Journal of Medicine explores the impact of regulations on the rising cost of cancer drugs, including those for the treatment of multiple myeloma such as thalidomide (Thalomid), Revlimid (lenalidomide), and Velcade (bortezomib).

The report’s author, Dr. Peter B. Bach, notes how only 15 years ago there was just one common cancer drug on the market costing over $2,500 a month. Now, he says, it is quite common to see drugs enter the market costing many times that amount.

Overall, spending on cancer drugs has risen faster than spending in many other areas of health care due to both rising prices and the ever-increasing rate of use.

The rise in drug prices has affected all types of cancer, including multiple myeloma. Drugs such as Velcade and Revlimid, for example, cost more than $5,000 per month at commonly prescribed doses.

Bach argues that Federal and state regulations have played an important role in the recent run-up in cancer drug prices.

“I believe the growth can be attributed primarily to a unique legislative and regulatory framework that shields cancer drugs from the strategies that health care payers such as Medicare typically use to hold down the price and utilization of drugs and other health care goods,” said Bach.

Bach realizes that policy makers are now faced with a tough situation, as they must somehow work to decrease the cost of cancer drugs and patient out-of-pocket expenses, while also attempting not to “stifle beneficial innovation.”

He offers several approaches that might work. For example, current laws that limit Medicare’s flexibility with drug prices could be amended or reversed. Medicare could also help control price inflation through the ability to conclude that several drugs are clinically interchangeable. According to Bach, Medicare can “either encourage price competition among the manufacturers of interchangeable drugs or engage third-party intermediaries to negotiate directly with manufacturers to obtain lower prices.”

For more information, see the full text of Bach’s report or the Leukemia & Lymphoma Society’s recent article about the report.