Kimmtrak is the only FDA-approved drug that works in fighting metastatic uveal melanoma (a rare cancer of the eye), but costs $50,000 per week.
A new cancer drug has been shown to prolong life for those suffering from a rare type of eye cancer. However, the people who need it are finding certain hospitals and insurance companies reluctant to pay its steep cost. Each weekly infusion costs nearly $50,000 per week, making it impossible for most people to afford it without insurance coverage.
Uveal melanoma is the most common type of intraocular cancer (cancer inside the eye) in adults but it only makes up 3 to 5 percent of all melanoma diagnoses. Patients with uveal melanoma that has spread to other parts of the body (metastatic cancer) have a poor prognosis, with an average survival rate of about 12 months. Kimmtrak is a cancer drug that was approved by the FDA in January 2022, touted as the “first and only” treatment available for metastatic uveal melanoma.
Kimmtrak’s manufacturer says the cancer drug has the ability to deliver a “six-month improvement in median overall survival” rates for people with metastatic uveal melanoma (mUM). It works for patients who have tested positive for human leukocyte antigen-A (HLA-A*02:01). This cancer drug is not chemotherapy or radiation therapy; rather it’s an immunotherapy that mobilizes and activates immune system T cells to fight uveal melanoma tumor cells.
Because Kimmtrak is delivered in the form of an IV infusion—which takes around 20 minutes to deliver in an office or hospital setting—it automatically incurs more cost than simply swallowing a pill at home. Even so, cancer drug costs have soared over the past few decades. Dr. Hagop Kantarjian, leukemia department chair at MD Anderson Cancer Center in Texas, told NPR that the manufacturer’s charge for annual cancer drug treatment has soared from $10,000 in the late 1990s to more than $200,000 today.
Hospitals are also guilty of inflating cancer drug costs on their bills and the cost it takes to administer infusions. Stacie Dusetzina, a health policy and drug pricing expert at Vanderbilt University Medical Center, said they do this “so that if someone doesn’t pay, [the hospital] can write it off.” The end result is that patients with mUM and other forms of cancer simply cannot handle paying the price for the medication they need.
NPR featured the story of Paul Davis, a 71-year-old retired physician in Findlay, Ohio, who suffers from mUM. After receiving several rounds of Kimmtrak—and having the cancer drug stabilize his tumors—Medicare stopped paying the bills for his infusions. His oncologist had wanted Davis to stay on the drug as long as it continued to prolong his life.
But when Davis switched from a Columbus-based hospital to one closer to home for his weekly infusions, Medicare rejected the claims. Davis now has a patient relations liaison working on his behalf, who says that the refusal to pay was due to a coding mistake. The new hospital had somehow said Kimmtrack was given to Davis for a different type of cancer, one that the FDA had not approved for its use.
Appealing these insurance decisions is usually a lengthy process, taking around 45 days. This means patients like Davis miss out on over six weeks of treatment while waiting on a decision. For cancers with a short prognosis, like mUM, these lapses in treatment can significantly shorten the patient’s life.
Patients for Affordable Drugs is an advocacy group that’s fighting to bring cancer drugs and other prescription drug prices under control. Executive director Merith Basey said, “It’s simple: Drugs don’t work if people can’t afford them … no one should be poor because they are sick or be sick because they are poor.” Prescription drug cost inflation is particularly rough on Medicare recipients, whose median income is around $26,200 per year.