While cancer drugs are curing many Americans, the exorbitant cost of cancer drugs is also keeping many other Americans from the proper treatment of their cancer! Newly launched cancer drugs now average $283,000 per year! (Beasley) Some patients who do not have insurance coverage, or do not qualify for low-income discounts, are forced to forgo treatment. In fact, “1 in 3 Americans on Medicare who don’t qualify for low-income subsidies do not fill prescriptions for cancer drugs.” (Lovelace) That is because their out-of- pocket cost, even after the Medicare payment, is still too prohibitive. According to Derek Beres, ”42% of new cancer patients deplete their life savings during the first two years of treatment.” (Dickinson)
My wife had multiple myeloma, a type of cancer of the blood cells. Her primary cancer medication is called Revlimid (the generic name is Lenalidomide). In September 2023, Tricare (our military insurance provider) paid $10,891.29 for 14, 25mg, generic Lenalidomide capsules (in her case to be taken one per day for 7 days, then 7 days off, then repeated). In other words, 14 capsules cover a 4-week period. That is $777.95 per capsule! In January of 2024, Tricare paid $11,898.45 for the brand name Revlimid ($849.88 per capsule). For some inexplicable reason, Tricare is requiring the purchase of the brand name drug rather than the less expensive generic Lenalidomide. (Accredo) In 2020, a 30-day supply of Revlimid in Australia sold for $4,900 and in Canada for $8,200. In the U.S. Revlimid sold for a whopping $22,000 for a 30-day supply! (Mikulic)
So, how were these costs established and what can we do about it? Sometimes, the pharmaceutical industry gives major discounts to low-income patients. It is commonly known that it can cost 1-2 billion dollars or more to bring a major drug to market. Many drugs in development never reach the market, so successful drugs must cover these costs. “Only 10-20% of drugs tested are successful and reach the market.” (Rujkumur) It can take 12 years in development and testing for a drug prior to FDA approval. Once approved, patent rights last for 7 years before generics come to the market. However, the initial patent can be extended by filing “new patents on the same drug in order to prolong monopoly.” (Rujkumar)
Celgene launched Revlimid in late 2005. Revlimid was derivative of Thalidomide (used for treating morning sickness during pregnancy but banned in the 1950’s for causing deformities in babies). Additional research by Rockefeller U. revealed that it had value for treating HIV/Aids. Celgene bought the rights for Thalidomide and found uses for it in treating leprosy, and eventually after combining it with the compound Lenalidomide discovered that it could inhibit tumor growth. Additional testing by Celgene found that the drug could be used in the treatment of multiple myeloma. It cost Celgene an additional $800 million dollars in research and testing before Revlimid was approved by the FDA. (Amin)
In a 2020 Congressional hearing, Rep. Katie Porter revealed that Celgene had raised the price of Revlimid 21 times from $215 per pill in 2005 to $765 in 2020, and how the CEO’s salary also increased significantly during this time. (Gandel) Celgene was purchased by Bristol Myers Squib (BMS) in 2019. Delays in Congressional oversight and regulatory changes may be influenced by the effective lobbying of the pharmaceutical and health care industry and by their contributions to the campaigns of our Congressional representatives. In 2020, 318 million dollars was spent on lobbying by the pharmaceutical and health products industry. (Open Secrets). In the same year, the pharmaceutical industry contributed 14 million dollars in campaign funds to two-thirds of our members in Congress! (Facher)
From 2008 to 2024, Celgene’s and Bristol Myers Squibb’s Revlimid revenues are expected to reach approximately 100 billion dollars! (Mikulic). That is 120 times Celgene’s cost of developing Revlimid! Merck’s Keytruda, a more recent cancer medication, had sales of about 69 billion in only 4 years (2020 to 2023)! (GlobalData).
Celgene/BMS has filed nearly 200 patent applications (109 granted by the U.S. Patent office) giving them a virtual monopoly on the drug for years. Additionally, they are blocking competition by making arrangements with generic companies to limit their production and thereby keeping the price high. (Amin).
We will always need new drugs to cure our illnesses and improve our quality of life. Pharmaceutical companies need to be incentivized with the potential for large revenues on their blockbuster drugs. Without those revenues, they cannot absorb the losses on the approximately 85% of the drugs that never make it through development and testing and still produce a positive net income. For these cancer drugs, there should be clarity on fair profit versus excessive price manipulation.
In conclusion:
- When cancer victims cannot afford cancer drugs or are risking their entire life savings on cancer drugs, then something needs to change.
- When Medicare, Tricare, and other government insurance programs are going broke (partly due to the excessive cost of cancer drugs), then something needs to change.
- When pharmaceutical companies are permitted to extend their patent protection beyond reasonable limits and induce generic companies to keep their prices close to those of brand name drugs, then something needs to change.
- When the pharmaceutical and health care industry spends hundreds of millions of dollars on lobbying and Congressional campaigns, while Congress does nothing to put reasonable controls on the profits of cancer drugs, then something needs to change.
- When we can buy these drugs for less from other countries, and are not doing so, then something needs to change. Fortunately, President Trump recently issued an executive order that we should be paying no more than what is paid for drugs in other countries. If drug companies do not cooperate, then Medicare and other government programs will match the rates paid in other countries. (Lupkin)
- Lastly, we are not talking about discretionary consumer items. We are talking about vital, life-saving drugs to fight cancer. If the pharmaceutical industry fails to self-regulate, government oversight becomes necessary. Currently, both are unconscionably absent from the scene.
Written by Ron Ohlhausen
January, 2024
Updated June, 2025
Bibliography
Accredo. Phone call with Accredo on January 16, 2024. Accredo is the Specialty Pharmacy that fills my wife’s prescription for Revlimid/Lenalidomide. The main cost is paid by Tricare for Life (our military health insurance program) through Express Scripts Pharmacy.
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