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Some expensive approved cancer drugs probably work as well at lower doses, as reduced-dose abiraterone with food and extended-interval checkpoint inhibitors suggest. Companies will not test this, so payers should fund randomised non-inferiority trials prioritised by spend and pharmacology, and use the results in reimbursement.
Payers and public agencies fund randomised non-inferiority trials of reduced doses or less frequent schedules of high-cost approved agents, prioritised by spend and by pharmacological plausibility (saturated target, flat exposure-response, long half-life). Precedents include reduced-dose abiraterone with food and reduced-dose or extended-interval checkpoint inhibitors. Results are used directly in reimbursement.
Shares Wrong doses, Prices and value, Nivolumab, Pembrolizumab.
Shares Prices and value, Nivolumab, Pembrolizumab, Immune checkpoint inhibitors.
Shares Wrong doses, Imatinib, Small-molecule kinase inhibitors.
Shares Wrong doses, Imatinib, Small-molecule kinase inhibitors.
Shares Wrong doses, Prices and value, Nivolumab, Pembrolizumab.
Shares Wrong doses, Prices and value, Small-molecule kinase inhibitors.
Shares Imatinib, Prices and value, Pembrolizumab.
Shares Wrong doses, Small-molecule kinase inhibitors, Immune checkpoint inhibitors.