For Whom the Price Escalates: High Price and Uncertain Value of Cancer Drugs

Gyeongseon Shin, Hye Young Kwon, Seungjin Bae

Research output: Contribution to journalComment/debate

7 Scopus citations


The price of cancer drugs has skyrocketed, yet it is not clear whether their value is commen-surate with their price. More cancer drugs are approved under expedited review, which considers less rigorous clinical evidence, yet only 20% of them show an overall survival gain in the confirmatory trial. Moreover, clinical data are often generated based on small, single-arm studies with surrogate outcomes, challenging economic evaluation. With their high price and uncertain (marginal) clinical value, cancer drugs are frequently rejected by health technology assessment (HTA) bodies. Therefore, agencies, including the UK’s National Institute for Health and Care Excellence (NICE), have adopted cancer drug funds (CDF) or risk-sharing schemes to provide extra access for expensive cancer drugs which fail to meet NICE’s cost effectiveness threshold. With rising pricing and fewer new cancer medications with novel mechanisms of action, it is unclear if newly marketed cancer therapies address unmet clinical needs or whether we are paying too much. Transparency, equity, innovativeness, and sustainability are all harmed by a “special” approach for cancer medications. If early access is allowed, confirmatory trials within a certain time frame and economic evaluation should be conducted, and label changes or disinvestment should be carried out based on those evaluations.

Original languageEnglish
Article number4204
JournalInternational Journal of Environmental Research and Public Health
Issue number7
StatePublished - 1 Apr 2022

Bibliographical note

Funding Information:
This research was supported by the National Research Foundation NRF-2021R1F1A1050281.

Publisher Copyright:
© 2022 by the authors. Licensee MDPI, Basel, Switzerland.


  • cancer drug
  • economic evaluation
  • expedited review
  • oncology drug
  • value


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