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Researchers Challenge Low Expectations In Treating Cancer In Poor Countries

14 points by JPLeRouzic 7y ago

pkilgore 7y ago
> "There's this myth that treating cancer is expensive," ... "And that's because the data is almost all from high-income countries..." > Much of the savings, the authors report, comes from the low cost of labor, which for the entire cancer center amounted to less than the average annual salary for one oncologist in the United States. It's interesting because I too have been guilty of seeing a price in dollars and not adjusting for the fact that amount may have vastly different spending power even within the United States (and thus, less needed for the same services where there is greater spending power).
tyingq 7y ago
"myth that treating cancer is expensive" They use Burkitt's lymphoma as the example. The treatment is intense, but short duration chemo, and no radiation, or surgery...and less radiology, cat scans, pet scans, etc. That cuts out a lot of costs. I'd be interested in what breast cancer, esophageal cancer, etc, cost in the same region. Those require longer and more rounds of chemo, radiation, surgery, etc.
hprotagonist 7y ago
Sometimes it's not a myth. We can _cure_ a few kinds of leukemia with T-cell therapies. There is no way we know of to do so cheaply. https://www.newyorker.com/magazine/2019/07/22/the-promise-and-price-of-cellular-therapies https://www.newyorker.com/magazine/2019/07/22/the-promise-an... Perhaps the most immediate implication of the blurring of lines between procedure and drug is the conundrum of price. A single dose of Kymriah for pediatric ALL is priced at $475,000; for Yescarta, a CD19 T-cell therapy designed for certain types of non-Hodgkin’s lymphoma, that number is $373,000. These prices rival those of some of the most expensive procedures in American medicine. (A kidney transplant can be priced at $415,000, a lung transplant at about $860,000.) And these price tags don’t include the delivery of post-therapy care to CAR-T patients, who typically suffer complications from the infusion. Subsequent hospital stays and supportive care can drive the total costs to a million dollars or more. ... Drug pricing is, of course, at the center of a familiar and inevitably acrimonious debate. The pharmaceutical industry defends high prices as a means to recoup the costs of drug discovery and development. Consumers, insurers, and governments argue that the prices charged for drugs are out of control, and bear no relationship to their real costs. But with cellular therapies the problem isn’t merely profiteering—it is that, unlike conventional drugs, cell therapies are inherently expensive to produce. The estimated cost to manufacture a typical CAR-T infusion is close to six figures. In short, even if CAR-T therapy were offered with no margin of profit, it would still rank with some of the most expensive procedures in medicine. Extracting cells from an individual patient, purifying them, genetically modifying them, and expanding their numbers into the millions will never be akin to churning out amoxicillin in a factory.
- martinald 7y ago
  There was an excellent BBC documenatry about this subject which may be of interest: https://www.bbc.co.uk/iplayer/episode/m0006nzt/war-in-the-blood https://www.bbc.co.uk/iplayer/episode/m0006nzt/war-in-the-bl...
dang 7y ago
The submitted title was '“There's this myth that treating cancer is expensive,” says Christian Rusangwa', which broke the site guidelines against editorializing in titles. Would you mind reviewing them? https://news.ycombinator.com/newsguidelines.html https://news.ycombinator.com/newsguidelines.html
- JPLeRouzic 7y ago
  I am sorry Dang, I read the rules a long time ago and never thought it was something forbidden. In the other hand I do not think the NPR title is very indicative of the content either: "How To Bring Cancer Care To The World's Poorest Children". Rwanda is certainly not the poorest country of the world, its large neighbor RDC, has the third of its GDP per capita in PPP. Rwanda is one of the most promising African countries. A long time ago it was labelled the "The Swiss of Africa". What is strange is that 30km to the west there is the North Kivu, one of the poorest place on Earth.

14 points by JPLeRouzic 7y ago

> "There's this myth that treating cancer is expensive," ... "And that's because the data is almost all from high-income countries..." > Much of the savings, the authors report, comes from the low cost of labor, which for the entire cancer center amounted to less than the average annual salary for one oncologist in the United States. It's interesting because I too have been guilty of seeing a price in dollars and not adjusting for the fact that amount may have vastly different spending power even within the United States (and thus, less needed for the same services where there is greater spending power).

tyingq 7y ago

"myth that treating cancer is expensive" They use Burkitt's lymphoma as the example. The treatment is intense, but short duration chemo, and no radiation, or surgery...and less radiology, cat scans, pet scans, etc. That cuts out a lot of costs. I'd be interested in what breast cancer, esophageal cancer, etc, cost in the same region. Those require longer and more rounds of chemo, radiation, surgery, etc.

hprotagonist 7y ago

Sometimes it's not a myth. We can _cure_ a few kinds of leukemia with T-cell therapies. There is no way we know of to do so cheaply. https://www.newyorker.com/magazine/2019/07/22/the-promise-and-price-of-cellular-therapies https://www.newyorker.com/magazine/2019/07/22/the-promise-an... Perhaps the most immediate implication of the blurring of lines between procedure and drug is the conundrum of price. A single dose of Kymriah for pediatric ALL is priced at $475,000; for Yescarta, a CD19 T-cell therapy designed for certain types of non-Hodgkin’s lymphoma, that number is $373,000. These prices rival those of some of the most expensive procedures in American medicine. (A kidney transplant can be priced at $415,000, a lung transplant at about $860,000.) And these price tags don’t include the delivery of post-therapy care to CAR-T patients, who typically suffer complications from the infusion. Subsequent hospital stays and supportive care can drive the total costs to a million dollars or more. ... Drug pricing is, of course, at the center of a familiar and inevitably acrimonious debate. The pharmaceutical industry defends high prices as a means to recoup the costs of drug discovery and development. Consumers, insurers, and governments argue that the prices charged for drugs are out of control, and bear no relationship to their real costs. But with cellular therapies the problem isn’t merely profiteering—it is that, unlike conventional drugs, cell therapies are inherently expensive to produce. The estimated cost to manufacture a typical CAR-T infusion is close to six figures. In short, even if CAR-T therapy were offered with no margin of profit, it would still rank with some of the most expensive procedures in medicine. Extracting cells from an individual patient, purifying them, genetically modifying them, and expanding their numbers into the millions will never be akin to churning out amoxicillin in a factory.

martinald 7y ago
There was an excellent BBC documenatry about this subject which may be of interest: https://www.bbc.co.uk/iplayer/episode/m0006nzt/war-in-the-blood https://www.bbc.co.uk/iplayer/episode/m0006nzt/war-in-the-bl...

dang 7y ago

The submitted title was '“There's this myth that treating cancer is expensive,” says Christian Rusangwa', which broke the site guidelines against editorializing in titles. Would you mind reviewing them? https://news.ycombinator.com/newsguidelines.html https://news.ycombinator.com/newsguidelines.html

JPLeRouzic 7y ago
I am sorry Dang, I read the rules a long time ago and never thought it was something forbidden. In the other hand I do not think the NPR title is very indicative of the content either: "How To Bring Cancer Care To The World's Poorest Children". Rwanda is certainly not the poorest country of the world, its large neighbor RDC, has the third of its GDP per capita in PPP. Rwanda is one of the most promising African countries. A long time ago it was labelled the "The Swiss of Africa". What is strange is that 30km to the west there is the North Kivu, one of the poorest place on Earth.