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More than a dozen cancer drugs that were approved based on so-called surrogate markers, such as the ability to shrink tumors, failed to improve the quality of life for patients. Yet most of the medicines, which previously were found not to extend lives, are also expensive, with many costing much more than $100,000 annually, and all but one remain on the market, according to a new analysis.

Of 18 cancer drugs approved between 2008 and 2012, only one registered an improved quality of life, and no statistically significant improvement was seen in six others compared with a placebo or an observation group. Four more showed mixed signs and two drugs actually displayed worsening patient outcomes. There was no available evidence for five medicines, according to the analysis in JAMA Internal Medicine.

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Meanwhile, the estimated annual costs of these 18 drugs ranged from about $20,200 for Rituxan, which is sold by Roche’s Genentech unit, to nearly $170,000 for Cometriq, a thyroid cancer treatment marketed by Exelixis. Cometriq, by the way, was one of two drugs that worsened quality of life and was also the most expensive treatment, according to the researchers. Costs were based on Medicare data.

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