His Cancer Meds Were Nearly $1K A Pill. How Did That Happen?
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Why are cancer drugs so expensive?
This is Fresh Air. I'm Dave Davies. Our guest today, David Armstrong, is a veteran investigative reporter who in 2023 was writing stories about challenges for patients in American health care when he was suddenly plunged into his subject in a deeply personal way. He was diagnosed with multiple myeloma, an incurable blood cancer. He would soon be prescribed a drug called Revlimid, which is cheap to make but really expensive to buy. A single pill costs nearly $1,000, roughly the price of a new iPhone. Armstrong decided to research the development and marketing of the drug, and he discovered tactics used by drug companies to maintain monopolies on their medications as long as possible and keep prices high.
What is Revlimid and how is it related to thalidomide?
Revlimid is one of the best-selling pharmaceuticals of all time, with total sales of more than $100 billion. This is also remarkable since the parent compound in Revlimid, thalidomide, was banned in most of the world in the 1960s, after it was shown to cause severe birth defects when given to pregnant women. David Armstrong is a senior reporter for ProPublica who focuses on health care. He previously reported for STAT, the online service reporting on health and medicine, as well as the Boston Globe and the Wall Street Journal, where he shared a Pulitzer Prize for coverage of the 9-11 attacks. His new story about Revlimid is The Price of Remission. You can find it at the ProPublica website. Well, David Armstrong, welcome to Fresh Air.
Thanks for having me.
I want to begin with your illness and the drug that you need to treat it. Multiple myeloma is an incurable blood cancer. Tell us about its symptoms, the course it typically takes in the human body.
Sure. Well, I can describe to you what happened in my situation. And every case for every patient is a little bit different. But for me, it started with a pain in my side that wouldn't go away. It felt like, for many weeks, a bad runner's cramp. And I sought out care for it and went to a doctor who thought, you know, this is probably a muscle strain. But it ended up getting worse. And one morning I woke up and I couldn't get out of bed. I mean, I had to grip the wall. I was in so much pain that and decided to go to the emergency room. And it was there they did some testing, some scans. And what happens with a lot of multiple myeloma patients is the disease really impacts the bones. It gets in there with these things called lytic lesions, creates holes in the bones.
And many people don't know they have multiple myeloma until they break a bone. I talked to another patient who was golfing and took a swing and his spine, part of his spine literally collapsed. And And he went to the hospital, and that's how he found out he had this disease. So it often lurks without people knowing it's there, and it takes something fairly dramatic for a patient to discover it. So in my case, I found out that I had it and then began a course for drugs, including Revlimid.
And how long do typically patients live with this illness?
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Chapters
6 chapters
1
Why are cancer drugs so expensive?
1:07–1:52
2
What is Revlimid and how is it related to thalidomide?
1:52–6:11
3
How was Revlimid discovered to be effective for multiple myeloma?
6:11–13:56
4
How did Celgene maintain its monopoly on Revlimid?
13:56–18:15
5
What strategies did Celgene use to control drug pricing?
18:15–23:03
6
What was the impact of Celgene’s pricing strategy on the healthcare market?
23:03–46:56
Speakers
7 identifiedMore from Fresh Air
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