Based on the Forbes article linked below, a chemotherapy called “Opdivo (generic name nivolumab) will cost more than $143,000 annually per patient. If your health insurance policy requires that you make a 20% co-pay for this chemotherapy, you will have to pay about $28,600.That’s in addition to all the other charges you have or will incur as a cancer patient now and in the future.
According to knowledgeable people quoted in the article, the pros of the drug are:
Again, according to the article, what you get, on average, for your $29k will be an extra six months of life.
“Melanoma patients who received nivolumab in one clinical trial had a median overall survival (ED note- OS = length of life) of nearly 17 months. About 62% of patients receiving the drug were still alive one year after starting treatment, while 43% were still alive at two years.
Although the study didn’t directly compare nivolumab-treated patients with those who didn’t receive nivolumab,(ED note- Why note?) the survival rates compare favorably with historical norms for older treatments. Until a few years ago, patients with melanoma that had spread to other parts of the body could be expected to live for less than a year, on average.”
The comparison of previous melanoma therapies to Opdivo/nivolumab is the key here- mean overall survival for Opdivo? 17 months. Mean overall survival for older melanoma chemotherapies? Less than a year. Your $29k will buy you an increase in overall survival of about six months.
90 second video by IMS Health Informatics- listen for “2-6 months…”
To add insult to injury, a spokerperson from Bristol-Myers-Squibb justifies the highcost of this chemotherapy by saying:
“A spokeswoman said the company prices its medicines based on “the value they deliver to patients and society, the scientific innovation they represent and the investment required to support” drug research-and-development.”
Please keep in mind that there a a number of integrative, alternative and complementary therapies for melanoma.
Would you pay thousands of dollars a month for less than a year of life?
But what would you say if your diet could improve the efficacy of your immunotherapy regimen??? The third article linked below says that a diet high in fiber may help immunotherapy work better.
To apply the same cost-benefit thinking to the lung cancer drugs Zykadia and Xalkori, the cost of the drugs is “$13,200 per month and Xalkori, pproved in 2011, costs $11,500.”
Duration of response is just over 7 months for Zykandia and and between 9-11 months for Xalkori. If your insurance co-pay is 20% then you will pay $2,640 for Zykadia $2,300 for Xalkori for each of the 7-9/11 that you may live.
“The drug Opdivo, from Ono Pharmaceutical Co. 4528.TO -2.06% and Bristol-Myers Squibb Co. BMY +0.04% , is a so-called PD-1 inhibitor, a new type of drug that harnesses the body’s immune system to fight tumors, including melanoma…
I think it is important for me to include a cost-effectiveness analysis that makes more sense to me. Sovaldi, also a sky-high costing drug, holds the promise of a cure in the majority of patients treated.
Six months versus cured. You decide.
“Some of the new drugs have brought real medical advances for diseases that long confounded researchers. Sovaldi and the newer hepatitis-C treatments can cure many patients of infection in 12 weeks, studies have shown, preventing it from worsening to diseases like liver cancer…
“Government health officials, private insurers and some members of Congress expressed concern that the $84,000-per-patient drug—Sovaldi from Gilead Sciences Inc. GILD +0.36% —… Gilead said the drug has a high cure rate and can stave off more costly health interventions if the disease is left untreated””
“Of 93 patients treated with pembrolizumab (Keytruda), 14 developed thyroid dysfunction, for a 15% adverse event rate, shortly after treatment was initiated, said Danae Delivanis, MD, of the Mayo Clinic, Rochester, Minn., and colleagues. Nearly all patients who developed thyroid disorders also received ipilimumab (Yervoy)...”
“A diet rich in fiber may help some people being treated for melanoma respond to immunotherapy treatment by influencing the gut microbiome, according to a new study led by researchers at the Center for Cancer Research at the National Cancer Institute (NCI), part of the National Institutes of Health, and the University of Texas MD Anderson Cancer Center. Results from the study, which analyzed both people with melanoma and mouse models of the disease, appeared December 24, 2021, in Science.
Among patients with advanced melanoma who underwent immunotherapy with immune checkpoint blockers, those who consumed at least 20 grams a day of dietary fiber survived the longest without their disease progressing. In contrast, use of probiotic supplements appeared to lessen somewhat the effectiveness of immune checkpoint blocker regimens. Probiotics are live microorganisms typically consumed as a supplement to improve gut health…”