How Much Is Too Much?

Dr. Leonard Saltz

A combination of two drugs has had “truly, truly remarkable” results in treating skin cancer, a doctor from one of the nation’s leading cancer centers says.

But it costs too much.

Zosia Chustecka of the online journal Medscape Oncology reported on Monday about the comments of Dr. Leonard Saltz during the annual meeting of the American Society of Clinical Oncology in Chicago.

Saltz, with the Memorial Sloan Kettering Cancer Center in New York, spoke on Monday during what Chustecka called an “extra session” at the conference. Saltz has been vocal in the past about the high cost of cancer therapies, Chustecka wrote.

In his talk, Saltz spoke specifically of ipilimumab and nivolumab, both made by Bristol-Myers Squibb. They’ve achieved dramatic results in the treatment of metastatic melanoma, which was thought to be “basically untreatable” just five years ago, he said.

But “these drugs cost too much,” Saltz said.

How much?

Nivolumab costs $28.78 per milligram; a bargain compared to ipilimumab, which sots $157.46 per milligram. That’s about 4,000 times the cost of gold, Saltz said.

The median total cost per patient in the latest trial was just under $300,000, Chustecka reported. For a Medicare patient with a 20 percent co-pay, that would mean coming up with $60,000 out of pocket.

“This is unsustainable,” Chustecka quoted Saltz as saying. “We must acknowledge that there must be some upper limit to how much we can, as a society, afford to pay to treat each patient with cancer.”

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