New Pancreatic Cancer Drug's $120,000 Monthly Cost Sparks Patient Despair

A groundbreaking new drug for metastatic pancreatic cancer, Daraxorrasib, approved by the FDA last week, is offering hope to patients but presenting a daunting financial challenge. Dana, a 45-year-old patient who has been receiving the drug for two months through a compassionate use program, described it as "a revolution" that has significantly improved her well-being. However, with the program's expected closure following FDA approval, the drug's full price of approximately $40,000 (120,000 shekels) per month, totaling over a million shekels annually, will become prohibitive for most.

Dana expressed deep concern about how she will afford the treatment, stating, "I don't know what I'll do and how I'll pay out of my own pocket. These are crazy costs, but on the other hand, it's life, so you're willing to pay anything." She highlighted that Daraxorrasib targets a KRAS gene mutation, present in over 90% of pancreatic tumors, offering a significant advancement over traditional chemotherapy. Clinical trials showed a median survival of 13.2 months with Daraxorrasib compared to 6.7 months with chemotherapy.

Experts, including Professor Ido Wolff, head of oncology at Ichilov Medical Center, acknowledge the drug's efficacy but warn of the financial strain. He noted that while US prices are typically higher than in Israel, a new US pricing policy, the Most-Favored-Nation (MFN) mechanism, could reduce pharmaceutical companies' incentives to offer significant discounts to smaller markets like Israel. This could lead to higher effective prices for Israelis.

Professor Nadav Davidovitch of Ben-Gurion University pointed out that the high cost of innovative drugs like Daraxorrasib exacerbates existing structural issues within Israel's healthcare system. The annual budget for the health basket (the list of publicly funded treatments) is not adequately updated to reflect population growth, aging, and rising disease rates, leading to essential treatments being excluded. Patients are increasingly forced to rely on private insurance or out-of-pocket payments, widening health disparities.

Adding to the urgency, the earliest Daraxorrasib could be included in Israel's national health basket is January 2028, leaving patients facing exorbitant costs until then. Professor Wolff stated that without private insurance, patients would need to raise approximately 900,000 shekels for six months of treatment, a sum that could even strain private insurance coverage and potentially increase premiums.