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Top Oregon Health & Science University researcher to doctors: Rise up over drug prices


Oregonian (Portland, OR)

04-30-13

April 25--Brian Druker, a top researcher who heads the Knight Cancer Institute at Oregon Health & Science University, joined more than 100 cancer specialists Thursday questioning the price of Gleevec, the groundbreaking cancer drug that made him famous. It can cost patients $100,000 a year.

Druker wants the medical community to lead a broad movement that takes the fight for affordable life-saving drugs to Washington D.C.

"We need to elevate the debate about drug prices in this country," he said. "We can talk about whether patients can afford it or not, but there's a bigger issue here and that is, can the country afford it."

An editorial published in a medical journal Thursday was signed by more than 100 top researchers into the blood cancer known as chronic myeloid leukemia.

And while the cancer doctors are pointing the finger at Gleevec's maker, Novartis, their target is all of the high-priced newest generation cancer treatments. Health care costs won't come down without reasonable drug prices, Druker says.

He says that can be achieved while preserving drug companies' ability to make reasonable profits and continue to fund research.

"There needs to be a balance here," he said.

The signature of Druker, who has earned top awards for his research, will add greatly to the impact of the editorial, said its lead author, Dr. Hagop Kantarjian of the MD Anderson Cancer Center in Houston.

"He's one of the greatest researchers in the world," Kantarjian said, adding that Druker contributed "to a major degree" to the editorial.

Druker helped develop Gleevec in the 1990s, the drug widely hailed as pioneering other new cancer drugs. It targets an enzyme triggering blood cells to multiply out of control, smothering the disease. Today, the U.S. Food and Drug Administration has approved dozens of such targeted drugs for a variety of cancers, and many others are in development.

The editorial grew out of a conference of chronic myeloid leukemia specialists whose discussion shifted to cost.

Druker says he's been vocal about the price of Gleevec since 2007, so the decision to sign on to the editorial wasn't unprecedented. But he's gratified that this time, others are joining in -- and people seem to be listening.

The editorial appeared in the journal of the American Society of Hematology, called Blood. It notes that Gleevec costs far more in the United States than other countries and suggests that at a certain point, large profits become excessive, unethical, or as Kantarjian said, "extortion."

The New York Times reported the editorial Thursday, featuring OHSU patient Raven Riedesel of Winlock, Wash. Her treatment has been free under a drug trial for Tasigna, a relative of Gleevec also produced by Novartis. But the trial ends in November, when she and her husband will face co-payments of about $1,400 a month. As expensive as that is, she's fortunate insurance would cover the rest.

In an interview with The Oregonian, the 28-year-old mother of two said her chronic myeloid leukemia was detected in February 2012, and now is barely detectable -- not a threat.

"It's heartbreaking," she said of the drug company's pricing. "They kind of dangle your life right in front of you: 'We're going to need all of your financial assets in order to give you your life -- or we can give you five years, because that's the average life expectancy.'"

A Novartis spokesperson sent a statement defending the company's pricing, saying that those who can't afford drugs get help from the company's "generous patient assistance program."

Druker's deputy director at the Knight Cancer Institute, Dr. Tomasz Beer, says Druker did not consult with him or alert him to the editorial's release.

"However, I'm very excited," Beer said, adding that some prostate cancer drugs are also exorbitantly priced. As a researcher of new drugs, he said "it kind of takes the wind out of your sails when you see your patients not being able to afford them."

He's not worried about drug companies pulling their funding: "I think if somebody tries to retaliate, that would only galvanize the medical community on this issue. That would be very foolish."

Druker says he has long wrestled with the knowledge that the drug he helped develop is being priced out of reach for some.

While people have wondered if he made money off of the overpricing of Gleevec, Druker says he doesn't get royalties. "I've never gotten a penny of the sales of Gleevec."

Other countries' governments set drug prices, and Druker says while he thinks it's a good idea, he thinks what's more realistic in the United States would be government pressure to bring down the cost of life-saving medications.

He envisions a discussion that includes drug companies. "This is a debate that needs the attention of Congress."

He hopes other physicians join the fight. "There's strength in numbers. If we don't speak out, who will."

-- Nick Budnick

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(c)2013 The Oregonian (Portland, Ore.)

Visit The Oregonian (Portland, Ore.) at www.oregonian.com

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Copyright Oregonian (Portland, OR) 2013

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