Reducing the dosage of blockbuster cancer drugs could slash global health spending by more than 30 billion dollars each year while expanding access to life saving treatments, according to new research presented at the American Society of Clinical Oncology annual conference. The findings challenge standard dosing practices for some of the world’s most expensive medicines, including the top selling drug Keytruda.
Researchers from the University of Chicago analyzed 29 FDA approved cancer immunotherapies and targeted therapies. They found that 21 of these drugs might work just as well with lower doses or less frequent treatment. The potential savings range from 40,000 to 240,000 dollars per patient annually. Keytruda, known generically as pembrolizumab, accounted for the largest share of potential savings at more than 14 billion dollars per year globally. Other major drugs including Avastin, Tecentriq, and Opdivo could yield combined savings of more than 9 billion dollars annually.
The analysis relied on publicly available FDA data to understand how these antibody drugs behave in the body. The drugs stay active for a long time, suggesting that patients could take treatment less often while maintaining effective drug levels. In India, doctors at Tata Memorial Hospital in Mumbai have been testing this approach for nine years. One trial gave 380 patients with advanced lung cancer a low dose of Keytruda combined with chemotherapy. Patients lived longer and had slower cancer growth with similar side effects. “We found that by lowering the dose, we can expand access by 50 to 60 percent,” said oncologist Kumar Prabhash. Another trial tested a very low dose of Opdivo in more than 400 patients with advanced head and neck cancer, showing longer survival and fewer serious side effects.
Merck, the maker of Keytruda, stated that its FDA approved doses are based on extensive clinical evidence. However, the U.S. Department of Health and Human Services supports scaling back treatments when evidence shows it is safe. “Receiving less treatment while maintaining efficacy can improve a patient’s quality of life, lower costs, require fewer clinic visits, and reduce treatment related toxicity,” said Emily G. Hilliard, a department spokesperson. Researchers plan to extend their analysis to dozens more cancer drugs. For patients worldwide facing soaring drug costs and limited access, these studies offer a hopeful path toward more affordable and equally effective care.