John's Journal

A. Background • Cancer drug prices are increasing at an alarming rate (1), which is causing harm to patients. • Prices have increased more than tenfold (2) between 2000 (average price $5,000-$10,000 per year) and today (average price of new cancer drugs exceeds $120,000 per year). • The average price of cancer drugs is increasing by about $8,500 (3,4) a year. The average household income today for a family of four is $52,000, down 8% from a decade ago (5). • Even patients with insurance have out-of-pocket expenses of 20-25% (6). Since each American has a 1 of 3 lifetime chance of developing cancer, every one of us is at risk of being unable to pay for the prescription medicines that will control and cure our cancer. • This could force many families to decide whether to pay $25,000 a year for one cancer drug, about half the household income, or forgo the treatment to save the money for other necessities. • The high price of cancer drugs is causing harm (7) by shortening the lives of patients who cannot afford the treatment. This is an injustice (8) that creates differential treatment conditioned by financial status. B. Petition We request that our President, the Secretary of Health and Human Services (HHS), and all Members of the United States Congress, consider our petition and protest against high cancer drug prices by implementing the following strategies: 1) Allow Medicare to negotiate drug prices by removing all current legal restrictions. Allow Medicare to have the same right to negotiate drug prices as the U.S. Department of Veterans Affairs now enjoys; 2) Allow the importation of cancer drugs across U.S. borders, for personal use. Prices in Canada are sometimes close to fifty percent less than what we pay for the exact same cancer drugs in the United States; 3) Enact and sign into law, new federal legislation that prevents drug companies from delaying access to generic drugs (“Pay-for-Delay”) and extending the life of drug patents (Patent “Evergreening”); 4) Create a post FDA drug approval mechanism/organization/group/ concerned parties (that include the strong voice of patients and their advocates) to estimate/propose a fair price for the new treatment, based on its value to patients and health care; 5) Allow organizations such as the PCORI – the Patient-Centered Outcomes Research Institute (nonprofit, nongovernmental organization located in Washington, DC. created by the Patient Protection and Affordable Care Act) to include drug prices in their assessments of the value of drugs and treatments; 6) Request nonprofit organizations that represent cancer specialists and their patients - such as ASCO, ASH, ACS, LLS, and NCCN - develop guidelines to incorporate prices of drugs relative to treatment value. C. Conclusion • In the United States, all cancer patients must have immediate access to affordable prescription drugs in order to save their lives. • We believe the measures as outlined above, will allow market forces to work in favor of lower cancer drug prices. This will provide all cancer patients with equal access to the best treatments now available. • We believe the measures as outlined above, will be fair to both the cancer patient and to pharmaceutical companies. • This is Justice. References 1.     Kantarjian H, Rajkumar SV. Why Are Cancer Drugs So Expensive in the United States, and What Are the Solutions? Mayo Clin Proc. In Press 2/2015. 2.     Kantarjian H, Steensma D, Rius SJ, Elshaug A, Light D. High Cancer Drug Prices in the United States: Reasons and Proposed Solutions. J Oncol Pract. 2014; 10(4): 208-211. 3.     Howard D, Bach P, Berndt E, Conti R. Pricing in the Market for Anticancer Drugs. Journal of Economic Perspectives. 2015; 29(1): 139-162. 4.     Silverman E. High Prices for Cancer Drugs are set at Launch: “It’s Where the Action Is”. Wall Street Journal Pharmalot. January 21, 2015. Accessed online February 16, 2015. http://blogs.wsj.com/pharmalot/2015/01/21/high-prices-for-cancer-drugs-are-set-at-launch-its-where-the-action-is/ 5.     Household Income in the United States. Wikipedia. Accessed online February 26, 2015: http://en.wikipedia.org/wiki/Household_income_in_the_United_States 6.     Gould E. Increased Health Care Cost Sharing Works as Intended. It Burdens Patients Who Need Care the Most. Accessed online January 15, 2015: http://www.epi.org/publication/bp358-increased-health-care-cost-sharing-works/ 7.     Kantarjian H. 119 Collaborator Experts in CML. The price of drugs for chronic myeloid (CML) is a reflection of the unsustainable prices of cancer drugs: from the perspective of a large group of CML experts. Blood. 2013; 12(22): 4439-4442. 8.     Kantarjian H. Relevance of the Hippocratic Oath in the 21st Century. The ASCO Post. October 2014; 5(16). Image courtesy of amenic181 at FreeDigitalPhotos.net. This image is for illustration purposes only, and a simulation of cancer medications and their high cost.

David Wilcox performs at The Grey Eagle in his hometown of Asheville, NC. This was an extremely intimate show, due to a large snow storm that hit Asheville t...