每年48萬美元的藥丸反映癌症藥物價格的新常態（1/2）

Recently The New York Times reported the following:

A $480,000-a-Year Pill Reflects a New Normal for Cancer Drugs (1/2)

Rasonque, the new pancreatic cancer treatment from Revolution Medicines, illustrates the huge inflation in cancer drug prices over the past two decades.

The NYT - By Rebecca Robbins (Rebecca Robbins is a Times reporter covering the pharmaceutical industry. She has been reporting on health and medicine since 2015.)

Aug. 31, 2026, 5:03 a.m. ET

Revolution Medicines set a sticker price of about $480,000 a year, or $663 a tablet, for its new pancreatic cancer drug — a cost that would have once been unthinkably high.

Today, such prices are routine for cancer drugs.

One cutting-edge CAR-T therapy now goes for $600,000 for a one-time infusion. A competitor, given the same way, is listed at $550,000. A daily pill for gastrointestinal cancer has a sticker price of $520,000 a year. A twice-daily pill for leukemia? It’s $430,000 a year.

In 2024 alone, nine cancer drugs were approved and then introduced with sticker prices above $400,000 annually, according to a tally by the Institute for Clinical and Economic Review, which evaluates the value of medicines.

That these prices have become commonplace would have been hard to imagine two decades ago, when even the prospect of a $100,000-a-year cancer drug evoked fierce criticism.

But since then, cancer drug prices have steadily increased, with few constraints beyond what a company thinks the market will bear. The expense is borne by government programs like Medicare, employers, patients and Americans who pay taxes and health insurance premiums.

A spokesman for Revolution Medicines, Brian Crawford, said the price of its new drug, Rasonque, “reflects its differentiation and the meaningful benefit it provides for patients.”

As is typical with other cancer drugs, the vast majority of the cost of Rasonque is expected to be covered through insurance, with varying out-of-pocket costs for patients. Mr. Crawford said uninsured and underinsured patients who met certain financial and medical criteria would receive the drug for free. The drug, also known as daraxonrasib, is taken as two pills a day.

In the medical world, much of the anger over cancer drug prices has been directed at pricey medicines that either failed or did not undergo clinical trials assessing whether they extend lives. Those drugs won approval because they could shrink tumors or delay their growth.

Revolution Medicines’ drug is not a cure, but it has shown that it can prolong life expectancy. In a key clinical trial, patients with advanced pancreatic cancer who got the pill lived for a median of 13.2 months, compared with 6.7 months for those who got chemotherapy.

Those results have electrified pancreatic cancer specialists and patients because they occurred in people who had no good treatment options and little time left to live.

In that context, it’s hard to say whether Revolution Medicines’ price is fair, said Stacie Dusetzina, a health policy professor at Vanderbilt University who studies drug pricing. “This drug does have substantial clinical benefits over existing treatment, which isn’t always the case for high-priced cancer drugs,” she said.

Cancer patients often stay on a drug for only a matter of months, stopping because it has become too toxic or their cancer has progressed. For example, in the clinical trial that won approval for Rasonque, patients were on the drug for a median of six months. But even over several months, the costs can pile up, and some patients who respond well can stay on a cancer drug for years.

Over the years, the public and lawmakers have expressed outrage at the high costs of insulin and drugs for H.I.V., hepatitis C and, most recently, obesity. One-time therapies for rare genetic diseases now routinely carry price tags of a few million dollars.

But cancer holds a unique place in the system, because care and drugs are so expensive and affect so many people.

For the past five years, employers have said cancer is the top disease category driving their medical expenses, according to a survey published in late August by the Business Group on Health, which represents large employers that provide health insurance to their workers.

Compounding the rising costs is that in some cancers, like multiple myeloma, patients are now routinely given three or four therapies at once.

The high prices aren’t limited to drugs that treat small numbers of patients. Oncology’s biggest blockbuster is Keytruda, which has a sticker price of $213,000 a year. It is given as an infusion or an injection every few weeks and has been used to treat several million patients.

For many older drugs, generic competition and government negotiations have sharply driven down costs. But there are hardly any limits on manufacturers’ ability to set high prices for newly approved medications.

“We allow pharmaceutical companies to charge whatever they want, and without any clear rationale, other than how much they think they can get,” said Dr. Aaron Kesselheim, a professor of medicine at Harvard and Brigham and Women’s Hospital who studies drug pricing.

(to be continued)

Translation

每年48萬美元的藥丸反映癌症藥物價格的新常態（1/2）

Revolution Medicines公司推出的新型胰臟癌治療藥物Rasonque，凸顯了過去二十年來癌症藥物價格的巨額上漲

Revolution Medicines公司為其新型胰臟癌藥物設定的標價約為每年48萬美元，即每片663美元 - 這在過去是難以想像的高昂價格。

如今，這樣的價格已成為癌症藥物的常態。

有一種尖端的CAR-T療法，一次性注入的費用就高達60萬美元。同樣的藥物，競爭對手的定價為 55 萬美元。一種治療胃腸道癌症的每日服藥，每年的價格高達 52 萬美元。一種治療白血病的每日兩次服藥呢？每年的標價為 43 萬美元。

根據評估藥物價值的臨床與經濟評估研究所 (ICER) 統計，光是 2024 年，就有九種癌症藥物獲準上市，其標價均超過每年 40 萬美元。

二十年前是難以想像的高昂價格如今已司空見慣。那時，即使是每年 10 萬美元的癌症藥物都會引發激烈的批評。

但自那時開始，癌症藥物的價格一直在穩步上漲，除了製藥公司認為市場能夠負擔的價格之外，幾乎沒有其他限制。最終，這筆費用由政府計劃如Medicare (聯邦醫療保險）、雇主、病患以及繳稅和醫療保險費的美國民眾承擔。

Revolution Medicines公司的發言人Brian Crawford表示，其新藥Rasonque的定價「體現了該藥的獨特性及其為患者帶來的顯著益處」。

與其他癌症藥物一樣，Rasonque的大部分費用預計將由保險覆蓋，患者只需自付一部分費用。Crawford先生表示，符合特定經濟和醫療條件的無保險或保險不足的患者將免費獲得該藥。該藥也稱為daraxonrasib，每日服用兩片。

在醫學界，人們對癌症藥物價格的憤怒大多集中在那些價格昂貴但療效不佳，或未經過臨床試驗評估是否能延長患者壽命的藥物。這些藥物之所以獲批，是因為它們能夠縮小腫瘤或延緩腫瘤生長。

Revolution Medicines公司的這款藥物並非治癒癌症的藥物，但已證明它可以延長患者的預期壽命。在一項關鍵的臨床試驗中，接受口服藥物治療的晚期胰臟癌患者的中位存活期為13.2個月，而接受化療的患者中位存活期僅為6.7個月。

這些結果令胰臟癌專家和患者都感到振奮，因為這些患者先前幾乎沒有有效的治療選擇，生命所剩無幾。

Vanderbilt大學研究藥物定價的衛生政策教授Stacie Dusetzina表示，在這種情況下，很難判斷Revolution Medicines公司的定價是否合理。 她說:「這種藥物確實比現有療法具有顯著的臨床效益，而高價抗癌藥物並非總是有明顯效益的」。

癌症患者通常只能服用一種藥物幾個月，就會因為藥物毒性過大或癌症擴展而停藥。例如，在為Rasonque贏得批准的臨床試驗中，患者的中位用藥時間為六個月。但即使只有幾個月，費用也會累積起來，一些有療效顯著的患者可以服用抗癌藥物數年之久。

多年來，公眾和立法者一直對胰島素以及治療愛滋病、丙型肝炎和最近肥胖症的藥物的高昂費用表示憤慨。如今，罕見遺傳疾病的一次性治療費用通常高達數百萬美元。

但癌症在醫療體系中佔有特殊的地位，因為癌症的治療和藥物費用極為昂貴，而且影響著許多人。

根據代表為員工提供醫療保險的大型雇主的「商業健康集團」（Business Group on Health）8月下旬發佈的一項調查，過去五年，雇主表示癌症是推高其醫療支出的首要疾病類別。

雪上加霜的是，對於某些癌症，例如多發性骨髓瘤，患者現在通常需要同時接受三到四種療法。

高昂的價格並非僅限於治療患者人數較少的藥物。腫瘤科最暢銷的藥物是Keytruda，年定價高達21. 3萬美元。該藥每隔幾週透過輸液或註射給藥，已用於治療數百萬名患者。

對於許多舊藥而言對於許多，，仿製藥的競爭和政府的談判已大幅降低了價格。但對於新核准的藥物，藥廠幾乎不受任何限制地設定高價。

哈佛大學和布萊根婦女醫院研究藥品定價的醫學教授Aaron Kesselheim博士說:「我們允許製藥公司隨意定價是沒有任何明確的理由，除了他們認為這藥能夠賺到多少」。

（待續）