To the Editor Goldstein et al1 pledged for value-based pricing for cancer drugs and evaluated incremental cost-effectiveness ratios for the use of necitumumab in patients with metastatic squamous-cell lung cancer. Because necitumumab therapy increased both median overall survival—but only by 1.6 months—and the number of patients with at least 1 grade 3 or worse adverse event (388 of 538 [72%] vs 333 of 541 [62%]), the harm/benefit ratio is a complex clinical issue that can hardly be solved by mathematical models.2 The present problem may be not the cost but the need for further research to identify predictive biomarkers for selecting the patients who will experience a relevant benefit in terms of quality of life.
Braillon A. Perspectives in Oncology Drug Pricing. JAMA Oncol. 2016;2(3):401-402. doi:10.1001/jamaoncol.2015.5003