5 ms·

I'm between two sides on this. Access to new life saving medications is fantastic and therefore should be celebrated. On the other hand, cost of the drug makes

I'm between two sides on this. Access to new life saving medications is fantastic and therefore should be celebrated. On the other hand, cost of the drug makes it inaccessible to a wide range of people. Maybe someone more knowledgeable than me can explain: do we as a society aim to improve public health on the cheap, or go headfirst into personalized medicine, knowing that we will be spending way more?

JBReefer 9y ago
I'm pretty sure people dying of cancer suddenly stop caring about philosophical questions about resource allocation. This is an unequivocally good thing - like that other expensive miracle drug, Harvoni.
- frugalmail 9y ago
  To save the time of others looking this up: > Harvoni is used to treat hepatitis C genotypes 1, 4, 5, or 6. This medicine is for use in adults and children who are at least 12 years old or who weigh at least 77 pounds (35 kilograms). source: https://www.drugs.com/harvoni.html https://www.drugs.com/harvoni.html
  - JBReefer 9y ago
    It cures Hep C, works faster and better than the current, horrible treatment, and because of that, costs $100,000 for a course of treatment. It's a fucking miracle.
    - maxerickson 9y ago
      Current US cash price is $33,000. (https://www.goodrx.com/harvonihttps://www.goodrx.com/harvoni https://www.goodrx.com/harvonihttps://www.goodrx.com/harvoni ) There is also increasingly coverage from Medicaid programs.
- throwaway91111 9y ago
  Not when your surviving family will be paying the bills for decades.
lekanwang 9y ago
I think there's false premise here that cancer has a single magic cure and we just need to focus on researching that instead of this expensive "personalized medicine." Cancer is a complex beast, and what we term cancer is really a whole class of diseases with a plethora of underlying causes, some of which we have a basic understanding, and others which we are only starting to understand. Saying we are treating "cancer" as a whole makes as much sense as saying we're treating "fever" or "pain." So what's billed as personalized medicine in cancer at least is really an entirely correct attempt to dig a layer deeper to understand the actual genetic variations that lead the cells to overmultiply, then attempt to address those root causes, numerous as they may be. We're currently still in the early stages of immunooncology, and the instruments are still blunt, but already more precise and informed than the chemo/radiation world. As for the cost side, breakthrough R&D like this is not cheap (hundreds of millions to billions), and manufacturing of humanized antibodies (the drug itself) ain't cheap either. We somehow need mechanisms in place so biotech research continues to take these big risks. It is however a completely valid question to ask how we can better derisk this kind of research to the right degree so that certain gaps in the market (e.g. diseases with no cure) can be researched and filled. Big pharma fills that derisking role for the vast majority of smaller biotechs and research labs, often buying up IP and running the hyper-expensive Phase 3's with a 90% chance of failure. The FDA/EMA have the most power in derisking for big pharma, with their very difficult job of balancing the derisking and encouraging research vs safety. Over time I'm sure the cost will decrease for immunooncology as we improve manufacturing and have get more data on their safety and efficacy profiles in the wild.
- nonbel 9y ago
  >"what we term cancer is really a whole class of diseases with a plethora of underlying causes" No, this is a new "talking point" come up with by cancer researchers due to their slow progress. Cancer research is up there with social psychology in terms of reproducibility problems, why not deal with that before claiming "it's so complex": http://www.nature.com/nature/journal/v483/n7391/full/483531a.html http://www.nature.com/nature/journal/v483/n7391/full/483531a... http://www.nature.com/news/cancer-reproducibility-project-scales-back-ambitions-1.18938 http://www.nature.com/news/cancer-reproducibility-project-sc... http://www.sciencemag.org/news/2017/01/rigorous-replication-effort-succeeds-just-two-five-cancer-papers http://www.sciencemag.org/news/2017/01/rigorous-replication-... Cancer is one disease, characterized by, amongst other things, aneuploidy: https://www.ncbi.nlm.nih.gov/pubmed/15549096 https://www.ncbi.nlm.nih.gov/pubmed/15549096 Detect and target the aneuploidy and you can have a general anti-cancer therapy.
Shivetya 9y ago
More than likely we do the years if not decade or more of expensive such medicines until the balance on knowledge is sufficient that churning out variations becomes cheap enough its viable for all. Think of like EVs, (early adopters of any tech for that matter) those with merely acceptable range were expensive for what they delivered but they are gradually becoming more efficient and at better cost levels. They won't be there for years to come but the people who paid this up front and helping those five to ten years down the road.

JBReefer 9y ago

I'm pretty sure people dying of cancer suddenly stop caring about philosophical questions about resource allocation. This is an unequivocally good thing - like that other expensive miracle drug, Harvoni.

frugalmail 9y ago
To save the time of others looking this up: > Harvoni is used to treat hepatitis C genotypes 1, 4, 5, or 6. This medicine is for use in adults and children who are at least 12 years old or who weigh at least 77 pounds (35 kilograms). source: https://www.drugs.com/harvoni.html https://www.drugs.com/harvoni.html
- JBReefer 9y ago
  It cures Hep C, works faster and better than the current, horrible treatment, and because of that, costs $100,000 for a course of treatment. It's a fucking miracle.
  - maxerickson 9y ago
    Current US cash price is $33,000. (https://www.goodrx.com/harvonihttps://www.goodrx.com/harvoni https://www.goodrx.com/harvonihttps://www.goodrx.com/harvoni ) There is also increasingly coverage from Medicaid programs.
throwaway91111 9y ago
Not when your surviving family will be paying the bills for decades.

lekanwang 9y ago

I think there's false premise here that cancer has a single magic cure and we just need to focus on researching that instead of this expensive "personalized medicine." Cancer is a complex beast, and what we term cancer is really a whole class of diseases with a plethora of underlying causes, some of which we have a basic understanding, and others which we are only starting to understand. Saying we are treating "cancer" as a whole makes as much sense as saying we're treating "fever" or "pain." So what's billed as personalized medicine in cancer at least is really an entirely correct attempt to dig a layer deeper to understand the actual genetic variations that lead the cells to overmultiply, then attempt to address those root causes, numerous as they may be. We're currently still in the early stages of immunooncology, and the instruments are still blunt, but already more precise and informed than the chemo/radiation world. As for the cost side, breakthrough R&D like this is not cheap (hundreds of millions to billions), and manufacturing of humanized antibodies (the drug itself) ain't cheap either. We somehow need mechanisms in place so biotech research continues to take these big risks. It is however a completely valid question to ask how we can better derisk this kind of research to the right degree so that certain gaps in the market (e.g. diseases with no cure) can be researched and filled. Big pharma fills that derisking role for the vast majority of smaller biotechs and research labs, often buying up IP and running the hyper-expensive Phase 3's with a 90% chance of failure. The FDA/EMA have the most power in derisking for big pharma, with their very difficult job of balancing the derisking and encouraging research vs safety. Over time I'm sure the cost will decrease for immunooncology as we improve manufacturing and have get more data on their safety and efficacy profiles in the wild.

nonbel 9y ago
>"what we term cancer is really a whole class of diseases with a plethora of underlying causes" No, this is a new "talking point" come up with by cancer researchers due to their slow progress. Cancer research is up there with social psychology in terms of reproducibility problems, why not deal with that before claiming "it's so complex": http://www.nature.com/nature/journal/v483/n7391/full/483531a.html http://www.nature.com/nature/journal/v483/n7391/full/483531a... http://www.nature.com/news/cancer-reproducibility-project-scales-back-ambitions-1.18938 http://www.nature.com/news/cancer-reproducibility-project-sc... http://www.sciencemag.org/news/2017/01/rigorous-replication-effort-succeeds-just-two-five-cancer-papers http://www.sciencemag.org/news/2017/01/rigorous-replication-... Cancer is one disease, characterized by, amongst other things, aneuploidy: https://www.ncbi.nlm.nih.gov/pubmed/15549096 https://www.ncbi.nlm.nih.gov/pubmed/15549096 Detect and target the aneuploidy and you can have a general anti-cancer therapy.

Shivetya 9y ago

More than likely we do the years if not decade or more of expensive such medicines until the balance on knowledge is sufficient that churning out variations becomes cheap enough its viable for all. Think of like EVs, (early adopters of any tech for that matter) those with merely acceptable range were expensive for what they delivered but they are gradually becoming more efficient and at better cost levels. They won't be there for years to come but the people who paid this up front and helping those five to ten years down the road.