What is the purpose of the DrugAbacus tool?

DrugAbacus was created by Dr. Peter B. Bach, and represents a draft of a tool that could be used to determine appropriate prices for cancer drugs based on what experts tend to list as possible components of a drug’s value. There is no doubt that drug prices in cancer have been causing a lot of worry, as they are rising rapidly. High prices drive out of pocket costs up, because coinsurance is calculated as a percentage of the price. In some insurance, like Medicare, in both Part B and D there is no upper limit on the out of pocket costs patients may face. Numerous systematic studies have documented that higher out of pocket costs lead patients to stop taking the medications that could improve their outcome. With the rising prices of cancer drug, how those prices should be tied to the drug’s value, or how that might be operationalized, are logical questions to ask.

Why aren’t all cancer drugs included in the DrugAbacus?

DrugAbacus contains a convenience sample assembled for the proof of concept of the tool. It includes the cancer drugs approved between 2001 and 2013 that were examined by Howard et al. (Dr. Bach was a co-author on that study), and all the cancer drugs approved after that paper was completed. Howard et al. did not include some drugs because they were used for symptom relief, and others because the effectiveness data were hard to locate.

What did you do about the fact that some drugs have multiple different indications and are effective different degrees in those indications?

While previous versions of DrugAbacus focused on effectiveness in a drug’s first indication, this version includes an Indication Specific Pricing feature, which allows users to compare the actual and Abacus price of a drug in multiple, different indications for Abraxane, Avastin, Nexavar, and Tarceva.

What about the fact that some drugs may help the average person only somewhat, but rare patients get huge benefits?

The chance that a drug helps a few people a lot is something that probably should be considered in the value of the drug, and it can likely be operationalized, but it has not been in this version of DrugAbacus.

Prices in the US are often much higher than those in other countries. how does the Abacus account for this?

The newest update allows users to compare prices across 3 different markets spanning 2 different countries. These include US Medicare, US Veterans Administration, UK, Ireland, Belgium, and Canada.

How are the components of drug pricing used in the tool defined? What are the sources for this information?

Visit our methods page to further understand how we determined the price components of tool.

How do I keep up to date with the DrugAbacus project, or give you feedback?

Stay up to date on the Evidence Driven Drug Pricing Project by signing up for our mailing list and following Dr. Bach on Twitter:@peterbachmd.

If you have any questions or feedback on the project or DrugAbacus tool, visit our contact page.