New Pancreatic Cancer Drug Costs Up to $90K a Month. Doctors Say the Price Puts Patients at Risk

Olivia Singh

10/27/20266 min read

James Howard says most people believe they would pay almost anything to stay alive.

The harder question, he says, comes when that belief is converted into an actual number.

“The question that nobody’s ever prepared to ask themselves is how much is your life worth ... and how long does that decision take for you,” Howard said.

For him, that number is currently about $90,000 a month.

Howard was diagnosed with pancreatic cancer in Vancouver in November 2025. He underwent chemotherapy, but the cancer has since spread and is now Stage 4.

Earlier this year, he learned about daraxonrasib, a new targeted cancer treatment approved by the U.S. Food and Drug Administration in August but not yet approved in Canada.

Taking three doses a day costs Howard approximately $63,000 US — about $90,000 Cdn — every month.

For him, the medication represents both hope and an extraordinary financial burden.

A Treatment Offering New Hope

Daraxonrasib targets a specific mutation found in some pancreatic cancer cells.

For doctors who have spent years treating pancreatic cancer, the drug’s trial results initially generated significant optimism.

Pancreatic cancer remains one of the most difficult cancers to treat, and survival rates are generally poor once the disease has spread.

Clinical research found that daraxonrasib stopped or reversed tumour progression in nearly one-third of participating patients.

That compared with roughly 10 per cent of patients receiving chemotherapy.

The treatment was also associated with median survival of approximately 13 months, compared with less than seven months for those receiving chemotherapy.

Dr. Christopher Booth, a medical oncologist in Kingston, Ont., said the results represented a rare sign of meaningful progress.

“It was a signal of hope that we finally started to see some progress in this very difficult disease,” Booth said.

But when the drug’s price was announced, that optimism quickly became mixed with concern.

A $480,000 US Annual Price

California-based Revolution Medicines set the U.S. launch price for daraxonrasib, marketed as Rasonque, at $480,000 US annually.

The wholesale price for a 30-day supply is approximately $40,000 US.

Patients who obtain the drug outside ordinary insurance or public funding systems can end up paying significantly more depending on dosage, pharmacy charges and other factors.

Howard says his own monthly cost is approximately $63,000 US.

For many oncologists, the scale of those numbers has become increasingly difficult to justify.

Booth, who has treated pancreatic cancer patients for more than two decades, is among more than two dozen cancer specialists who told Peazzi that rapidly increasing cancer drug prices are creating serious problems for patients and health systems.

He said pharmaceutical companies should be able to earn returns on drugs they develop.

But, he argues, there is a point at which pricing begins to work against the interests of the patients those drugs are designed to help.

“Corporate greed is going to harm patients and health systems,” Booth said.

Doctors Question How Prices Are Set

Booth recently co-authored a commentary in The Lancet Oncology arguing that drugs such as daraxonrasib illustrate what the authors describe as an “unrelenting upward spiral” in U.S. cancer drug prices.

Their concern extends beyond one medication.

When one new cancer treatment launches at an exceptionally high price, doctors worry it creates a benchmark that influences the pricing of future treatments.

That can gradually push the entire market upward.

Dr. Ramy Saleh, an associate professor of oncology at McGill University who studies early-stage clinical trials, said the price attached to some new medicines can be difficult to reconcile with their apparent manufacturing costs.

“Sometimes the prices they quote make absolutely no sense,” Saleh said.

He said he is not convinced that producing a drug priced at roughly half a million dollars annually comes anywhere close to costing that amount.

The gap between production cost, research expense and market price has become a central point of debate as oncology drugs grow increasingly sophisticated — and expensive.

Company Says Price Supports Innovation

Revolution Medicines says the price of daraxonrasib reflects the therapeutic benefit of the treatment and the investment required to continue developing new medicines.

In a statement to Peazzi, the company said the amount an individual patient pays can vary depending on treatment duration and insurance coverage.

“Our goal is to establish a price that reflects meaningful therapeutic advancement while supporting patient access and continued scientific innovation,” a spokesperson said.

The company has not yet applied to Health Canada for regulatory approval of daraxonrasib.

That means Canadian patients seeking the treatment generally cannot obtain it through standard public funding channels.

Doctors say some patients can gain access through clinical trials or compassionate-access programs, but those opportunities are limited.

For patients who do not qualify, paying privately may be the only immediate route.

Canada and the U.S. Handle Drug Pricing Differently

Doctors say part of the problem lies in how drug prices are established in the United States.

Booth describes the U.S. system for newly launched drugs as one that historically allows pharmaceutical companies significant freedom to set prices.

Federal negotiation over drug prices has traditionally been limited, although the 2022 Inflation Reduction Act introduced some negotiating authority for selected Medicare-covered medications.

Canada follows a different process.

Health Canada first determines whether a drug is safe and effective enough to be approved.

After that, provincial health systems and other agencies negotiate prices and decide whether a treatment will receive public coverage.

Canada’s Patented Medicine Prices Review Board also regulates patented drug prices.

But none of those protections necessarily help a Canadian patient seeking access to a treatment that has not yet been approved domestically.

U.S. Drug Prices Continue to Rise

The cost of newly launched drugs in the United States has risen substantially.

According to a recent report from the Boston-based Institute for Clinical and Economic Review, the median net price of newly launched U.S. drugs exceeded $250,000 US last year.

Three years earlier, the median was approximately $190,000 US.

That represents an increase of more than 35 per cent.

Doctors say these prices are increasingly affecting decisions far beyond the United States because the U.S. launch price can become an international benchmark.

When patients cannot wait for regulatory approval in their own countries, they may also end up purchasing medications directly from American pharmacies.

Patients Crying Over Access

Dr. Ralph Wong, a senior medical oncologist at CancerCare Manitoba, says the consequences are visible in his clinic.

“I’ve had multiple patients in my practice crying because they can’t access the drug,” Wong said.

He described the price of daraxonrasib as particularly troubling because patients facing advanced cancer have limited time and few treatment options.

Wong argues that setting a high launch price based largely on the clinical value demonstrated in trials places an enormous financial burden on people who are desperate for additional time.

Doctors say they frequently search for clinical trials, compassionate-access programs or other avenues that can provide medications at no cost.

But there is no guarantee a patient will qualify.

Longer Life at a ‘Crippling’ Price

For wealthy patients, a treatment costing tens of thousands of dollars every month may be possible for some time.

For most people, Booth said, it would be financially “crippling.”

Even a relatively short course can consume savings accumulated over decades.

At $90,000 a month, six months of treatment would cost roughly $540,000.

A full year would exceed $1 million.

Those costs can force patients and families into decisions involving retirement savings, homes, debt and inheritances at the same time they are already managing a life-threatening diagnosis.

Canadians Already Spending More on Medicines

Even without accounting for treatments purchased abroad, Canadian spending on patented medicines has been climbing.

According to the Patented Medicine Prices Review Board, sales of patented drugs reached $22.1 billion in 2024.

That represented an increase of nearly 11 per cent in one year.

Patented medicines accounted for approximately 47 per cent of all medicine spending in Canada, with 1,137 patented medicines approved for human use that year.

Those figures do not include the money Canadian patients may spend privately obtaining medications unavailable domestically.

Crossing the Border for Treatment

For Howard, accessing daraxonrasib involves more than writing a cheque.

Because the drug is not approved in Canada, he has to navigate the logistics of obtaining it in the United States.

That includes crossing the border to collect prescriptions sent to a U.S. postal address.

The process adds another layer of difficulty to an already overwhelming situation.

Howard compares the monthly expense to making a down payment on a condominium every few weeks.

“It’s not sustainable long term,” he said.

But sustainability is only one part of the calculation.

The other is time.

“If I can gain a quality of life which allows you to spend more time with family, that’s a significant bonus for me.”

What Is More Time Worth?

New cancer treatments are often celebrated for extending survival.

But as drug prices rise, physicians say those medical advances increasingly come with another question: who can afford to benefit from them?

For a patient with advanced cancer, an additional six months may mean holidays, birthdays, conversations and time with children or grandchildren that otherwise would not happen.

Assigning a financial value to that time is deeply uncomfortable.

Yet patients such as Howard are being forced to do exactly that.

Doctors who criticize current pricing practices are not arguing that pharmaceutical companies should develop treatments without earning a return.

Their concern is whether prices have risen so high that medical breakthroughs exist on paper but remain out of reach for many of the people who need them.

For pancreatic cancer patients in particular, that tension is especially acute.

A drug capable of nearly doubling median survival represents genuine progress against a disease where new options have historically been limited.

But when access can cost as much as a home down payment every month, that progress comes with an extraordinary condition.

Patients must first be able to afford it.

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