Here’s a little nugget from Health Affairs, in many ways the flagship journal of health policy.

“Abstract: Cancer drugs account for a growing share of health care expenditure, raising questions about how much value is gained from their use. We used a proprietary international data set to examine real-world cancer drug consumption and expenditure in the period 2004–14 in Australia, Canada, France, Germany, Italy, Japan, Sweden, the United Kingdom, and the United States and to explore the value obtained. Even after adjusting for population and epidemiological factors, we found that the United States spent more than the other countries on cancer drugs, yet it often had lower utilization. All nine countries—most notably France and Japan—witnessed an improvement in neoplasm-related years of potential life lost, which suggests that although the costs of drugs have risen, their therapeutic benefits have increased as well. Net economic value derived from cancer drug expenditures appears to have remained positive, with base-case analyses indicating that the United States obtained an estimated $32.6 billion in net positive return from cancer drug care in 2014. However, the United States lags behind other countries in health gains obtained per dollar spent.”

doi://10.1377/hlthaff.2015.1453, Health Affairs May 2016 vol. 35, no. 5 813 – 823

So basically, we pay more than other nations, per unit consumed, and interestingly, use less overall. I admit the second half of that sentence flies in the face of some things I believed, and I may have to make some amends to the oncologists of America. But really, the only reason we pay more is because we, as a nation, are willing to pay through the nose in order to avoid the specter of “government interference in the free market”.  (The other nations all have national or quasi-national entities that regulate drug prices). I’m not impressed that the free market has done much for us in this area, other than enrich the pharmaceutical industry.  Other analysis says that that enrichment has not returned to us even singlefold, never mind manifold, in new drug discovery (which is always what pharmaceutical companies insist is the value we get for paying All The Money for their product.  I think it might make sense to try some of that government interference.  These are drugs that work, and are, for a change, important.  (Unlike, say, the Cialises of this world, which work but are less important-not unimportant, mind you-just less.