- Research over a six-month span last year shows U.S. hospitals marked up the price of cancer therapies for patients with private health insurance, in some cases charging them more than seven times what it costs for hospitals to acquire the drugs, according to a study published Monday in JAMA Internal Medicine.
- Prices varied considerably across payers and facilities in the study, with the median drug price markup across all cancer centers and payers ranging between 118% and 634%.
- Researchers also found that most National Cancer Institute-designated facilities did not publicly disclose payer-specific prices for cancer therapies as required by federal price transparency regulations.
Last year the federal price transparency rule requiring hospitals to disclose negotiated prices for services went into effect. But it hasn't stopped hospitals from charging widely varying fees for procedures, sometimes even within the same facility.
That's true for cancer therapies too, as JAMA researchers found most cancer centers aren't complying with the price disclosure rule, and the prices they charge differ drastically across centers and for patients with different private insurance coverage.
Researchers examined private payer-specific negotiated prices for 25 commonly used injectable or infusible cancer therapies at 61 NCI-designated facilities. They used publicly available hospital price transparency files, conducting the study from April 1 to Oct. 15 of 2021.
Among the 61 NCI-designated cancer centers analyzed, just 44% disclosed private payer-specific prices for at least one top-selling cancer therapy.
Across different hospitals, price ratios for cancer therapies ranged between 2.2 for pertuzumab and 15.8 for leuprolide.
At the same cancer center, price ratios for cancer therapies ranged between payers from 1.8 for brentuximab to 2.5 for bevacizumab.
At one center, negotiated prices for 7.5 mg of leuprolide ranged between $692 and $3,284 per milligram, researchers found.
Public policies to discourage or prevent excessive hospital price markups on cancer therapies could benefit patients as rising costs are a major concern, researchers wrote.
U.S. spending on cancer therapies increased from $39.1 billion in 2015 to $67.5 billion in 2019, in large part due to manufacturer and hospital market power, according to the study.
Manufacturers benefit from time-limited monopolies during periods of patent and regulatory exclusivity, and hospitals then institute high prices for cancer therapies from private insurers, researchers wrote.