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Cancer drug pricing: deciphering the leaked e-mails

NEWS FLASH A group of hackers specialised in investigating the pharmaceutical industry has obtained thousands of e-mails in which major pharmaceutical companies discuss their methods for setting drug prices. Prescrire has gained access to the leaked documents...

Prescrire, the International Society of Drug Bulletins and several members of the Medicines in Europe Forum have conducted a joint investigation based on data provided by a group of hackers specialised in investigating the pharmaceutical industry. The hackers got their hands on around 10 000 e-mails sent by major pharmaceutical companies that were stored on a secure website. These e-mails were made available to academic teams and non-profit organisations, on condition that these groups could prove their independence from the pharmaceutical industry.

The preliminary analysis of the data, carried out in collaboration with six international teams specialised in pharmacoeconomics, focused on the mechanics of cancer drug pricing. The aim was to understand why most new cancer drugs marketed in the European Union are offered at prices corresponding to a treatment cost of about 5000 to 8000 euros per patient per month (1).

Could it be that this strange convergence of prices reflects no underlying factors other than simple coincidence? Which comes down to trying to prove a negative… in more ways than one. The pharmacoeconomic statistical tests developed for this investigation suggest that something more is going on.

Another hypothesis: could the phenomenon be due to some incompressible fixed cost contained within companies’ price-setting calculations, such as a secret levy of 4000 euros per month of treatment per cancer patient, payable to national drug regulatory agencies to fund research into accelerated marketing authorisation procedures? The European Medicines Agency (EMA) is already engaged in such research, and the PR and spin-doctoring involved have indeed been proving ruinously expensive.

The strongest hypothesis to emerge from our analysis was that of an agreement between pharmaceutical companies to extract as much money from universal healthcare systems as these systems can bear, and then just a little more, in accordance with the known hypothesis of "willingness to pay, but not for anybody else". The spokespersons of the companies implicated have refuted this hypothesis, claiming it to be "too obvious to be believable".

Be that as it may, there can be no doubt upon analysing these e-mail exchanges that the protagonists all knew each other, since they  are all members of an exclusive fly-fishing club, which meets every year in Paris on 1 April.

> Read the conclusions of Prescrire's Editors

©Prescrire 1 April 2017

Selected references from Prescrire’s literature search.
1- Anonymhoax "The Big Pharma email archive: who’s fooling whom?" 1 April 2017. www.ApriLeaks.org: 5 pages

"Prix des anticancéreux : décryptage d'une fuite de courriels" Rev Prescrire 2017 ; 37 (402) : 304. (Pdf in French, free)