“A full 2-year course of Keytruda can cost $385,000………………….”
By Eric Bricker
Highest Selling #Drug in America is… Keytruda. What’s Keytruda??
Keytruda is an infusion treatment for multiple types of cancer… mostly for Non-Small Cell Lung Cancer and Melanoma, but also for bladder cancer, kidney cancer and several other cancers.
Keytruda is an immunotherapy that allows a person’s own immune system to better attack cancer cells. Keytruda is not traditional chemotherapy and Keytruda does not directly kill cancer cells.
Keytruda has become a standard part of treatment for these cancers because it has significantly improved mortality. For Stage IV Lung Cancer, Keytruda improved 5-year survival from 10% to 30%. For Stage IV Melanoma, Keytruda improved 5-year survival from less than 10% to 40%.
Keytruda can be infused over 30 minutes every 3 weeks for up to 2 years, for a total of 35 cycles. There are other regimen frequencies as well.
Keytruda is billed to employer health plans from a provider via medical claims, not pharmacy claims. As such, Keytruda will not show up on a employer’s pharmacy spend from their PBM… It will show up on their medical spend.
Physician groups and hospitals buy Keytruda and then up charge the employer sponsored plan when they bill for it. One cycle of Keytruda can cost $11,000… I have seen it as high as $20,000. Accordingly, a full 2-year course of Keytruda can cost $385,000.
To lower Keytruda costs, it is best to have it infused at an independent oncologist’s practice and not at a hospital system or at an oncology practice owned by a hospital system. Independent oncologists do not up charge for Keytruda as much as hospitals.
