Monday, June 1, 2009

Patient = Machine for Maximizing Profit?

Gary Schwitzer on his blog Health News, cites a recent Forbes article raising the question: Are new cancer drugs worth the price?

From that article:

ORLANDO - At the annual meeting of the American Society for Clinical Oncology, giant banners with pictures of heroic cancer patients proclaim doctors are "Personalizing Cancer Care."

But many companies seem to be maximizing cancer profit instead. Big drug companies are making big money off smaller and smaller improvements in cancer care. Newfangled cancer drugs can cost $50,000 a year, and that doesn’t mean they will add a year to the patient’s life--you might spend $50,000 for a year and extend the patient's life by only weeks.

"We are wasting a lot of resources treating people with treatments they don't need," says Otis Brawley, chief medical officer at the American Cancer Society.

Drugs like Tarceva and AstraZeneca's ( AZN - news - people ) Iressa, which is no longer used in the U.S., work best in patients whose tumors have a mutation in the gene for the epidermal growth factor receptor (EGFR), which is involved in cell growth. In another lung cancer study, Tarceva only slightly delayed the median progression in the overall group of patients, but the small subset of patients with EGFR mutations in their tumors had a tenfold lower risk of the tumor progressing when they took Tarceva.

One of the most impressive results was not from a fancy new therapy at all. Alimta, a more traditional chemotherapy pill sold by Eli Lilly ( LLY - news - people ), didn't just slow tumor progression but also increased survival for patients with non-small-cell lung cancer by a median 2.8 months, extending survival to 13.4 months.

Some sort of cost/benefit analysis is obviously in order with respect to these new therapies. At our place, the University of Minnesota, the party line is that there are many new therapies just lurking around the corner and all we have to do is discover them. Then, voila!, they will be converted into cures for whatever, through the miracle of translational research.

As the Forbes article indicates: it really isn't that simple. A little honesty would go a long way in the current medical environment.

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