A few studies have estimated the costs of lost productivity, but these have generally considered individual cancer sites. While providing a useful insight into the proportion of economic costs related to individual cancers, they fail to yield an estimate of the overall burden of cancer-related premature mortality on the economy. Also, cancer control initiatives are often site-specific so estimates of productivity losses associated with different cancers are needed to inform decisions about allocation of healthcare funding between initiatives. For all cancers, the total cost of lost household production and caring activities was €107.6 million for males and €328.7 million for females. Male costs were €68.1 million for lost household production and €39.4 million for lost caregiving; female costs were €163.6 million and €165.1 m respectively. In females, the most costly site in terms of non-market activities was breast cancer (household production: €45.2 million; caregiving: €45.6 million). In males it was lung cancer (household production: €13.5 million; caregiving €7.8 million). Against this backdrop, drugmaker Merck & Co., Inc., also known as Merck Sharp & Dohme (MSD) outside the United States and Canada, revealed that advanced lung cancer patients who took its Keytruda immuno-oncology medicine in a large trial and were previously untreated, went longer without their disease worsening and showed a survival advantage over those given standard chemotherapy, said recently. An independent data monitoring board recommended that the late-stage trial be stopped due to the favorable results, MSD said, thereby allowing patients who were taking chemotherapy to switch over to the company's treatment. Keytruda, which takes the brakes off the immune system by blocking a protein called PD-1, is already approved for patients who have undergone previous chemotherapy for advanced non-small lung cancer. Patients enrolled in the trial had tumors with high levels of PD-L1, a related protein whose presence may help identify which patients are most likely to respond to Keytruda and similar drugs called checkpoint inhibitors. MSD hopes the new data will allow its injectable drug, which has a list price of about $150,000 a year, to be used earlier as a treatment for the most common form of lung cancer. Bristol-Myers Squibb Co's approved rival Opdivo is also being tested as a so-called first line treatment for NSCLC, with data expected later this year. Opdivo's studies have enrolled patients regardless of their PD-L1 levels, helping assure its wider use and greater sales than Keytruda. John Boris, an analyst with Suntrust Robinson Humphrey, on Thursday forecast that Keytruda will generate annual sales of $7 billion by 2021. But he predicted Keytruda will have only 25 to 30 percent of the first-line NSCLC market, while Opdivo commands a 65 to 70 percent market share. — Agencies
