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Abiraterone at a quarter dose with food matches full-dose exposure, and pembrolizumab and nivolumab can be given at longer intervals, but no manufacturer will fund trials that cut its own revenue. A public 'value trials' fund would run non-inferiority trials of lower doses and longer intervals for the highest-spend cancer drugs, with payers committing to adopt positive results.
Abiraterone at a quarter dose with food matched full-dose exposure; extended-interval pembrolizumab and nivolumab are supported by pharmacology; several kinase inhibitors are effective at reduced doses with less toxicity. Because no manufacturer will fund trials that cut its own revenue, these questions are answered slowly by academic groups. The proposal is a dedicated public 'value trials' fund (modelled on the Netherlands' ZonMw and the UK NIHR programmes) that prioritises dose and schedule de-escalation of the highest-spend oncology drugs using non-inferiority designs, with payers committing to adopt positive results.
Shares The high price of anticancer drugs: origins, implications, barriers, solutions, Prices and value, Nivolumab, Pembrolizumab.
Shares The high price of anticancer drugs: origins, implications, barriers, solutions, Global access and affordability roadmap: essential medicines and generics → biosimilars and frugal trials → reliance, pooling and homegrown innovation, Prices and value, Nivolumab.
Shares The high price of anticancer drugs: origins, implications, barriers, solutions, Prices and value, Nivolumab, Pembrolizumab.
Shares The high price of anticancer drugs: origins, implications, barriers, solutions, Global access and affordability roadmap: essential medicines and generics → biosimilars and frugal trials → reliance, pooling and homegrown innovation, Prices and value, Pembrolizumab.
Shares The high price of anticancer drugs: origins, implications, barriers, solutions, Global access and affordability roadmap: essential medicines and generics → biosimilars and frugal trials → reliance, pooling and homegrown innovation, Prices and value.
Shares The high price of anticancer drugs: origins, implications, barriers, solutions, Global access and affordability roadmap: essential medicines and generics → biosimilars and frugal trials → reliance, pooling and homegrown innovation, Prices and value.
Shares The high price of anticancer drugs: origins, implications, barriers, solutions, Wrong doses, Prices and value, Nivolumab.
Shares The high price of anticancer drugs: origins, implications, barriers, solutions, Global access and affordability roadmap: essential medicines and generics → biosimilars and frugal trials → reliance, pooling and homegrown innovation, Prices and value.