26-May-2011 – THE COSTLY WAR ON CANCER

26-May-2011 – THE COSTLY WAR ON CANCER

New cancer drugs are technically impressive. But must they cost so much?

CANCER is not one disease. It is many. Yet oncologists have long used the same blunt weapons to fight different types of cancer: cut the tumour out, zap it with radiation or blast it with chemotherapy that kills good cells as well as bad ones.

New cancer drugs are changing this. Scientists are now attacking specific mutations that drive specific forms of cancer. A breakthrough came more than a decade ago when Genentech, a Californian biotech firm, launched a drug that attacks breast-cancer cells with too much of a certain protein, HER2. In 2001 Novartis, a Swiss drugmaker, won approval for Gleevec, which treats chronic myeloid leukaemia by attacking another abnormal protein. Other drugs take different tacks. Avastin, introduced in America in 2004 by Genentech, starves tumours by striking the blood vessels that feed them. (Roche, another Swiss drug giant, bought Genentech and its busy cancer pipeline in 2009.)

These new drugs sell well. Last year Gleevec grossed $4.3 billion. Roche’s Herceptin (the HER2 drug) and Avastin did even better: $6 billion and $7.4 billion respectively. Cancer drugs could rescue big drugmakers from a tricky situation: more than $50 billion-worth of wares will lose patent protection in the next three years.

This month Pfizer, an American company, announced that America’s Food and Drug Administration (FDA) would speed up its review of a cancer drug called crizotinib. Roche submitted an FDA application for a new medicine, vemurafenib. The industry is pouring money into clinical trials for cancer drugs (see chart).
This is part of a shift in how big drug firms do business. For years they have relied on blockbusters that treat many people. Now they are investing in more personalised medicine: biotech drugs that treat small groups of patients more effectively.

Last year the FDA approved Provenge, developed by Dendreon of Seattle to train the immune system to fight prostate cancer. In March the FDA approved Yervoy, Bristol-Myers Squibb’s drug to treat melanoma. And there are promising drugs in the pipeline. Pfizer’s crizotinib attacks a protein encoded by a gene found in fewer than 5% of patients with non-small-cell lung cancer. Roche’s vemurafenib attacks advanced melanoma by blocking the mutated form of a gene, B-RAF. Both Pfizer and Roche are developing tests to help doctors identify suitable patients for their drugs.

The snag, from society’s point of view, is that all these drugs are horribly expensive. Last year biotech drugs accounted for 70% of the increase in pharmaceutical costs in America, according to Medco, a drug-plan manager. This trend will continue as drug firms develop new ways to treat, for example, multiple sclerosis and rheumatoid arthritis.

Cancer plays a huge role in raising costs. America’s National Institutes of Health predict that spending on all cancer treatment will rise from $125 billion last year to at least $158 billion in 2020. If drugs become pricier, as seems likely, that bill could rise to $207 billion.

Not all these new drugs work. In December the FDA said that Avastin’s side effects outweighed its meagre impact on breast cancer. (Genentech will argue otherwise in a hearing in June.) More generally, some people reckon that new cancer drugs offer small benefits at an exorbitant price. Provenge costs $93,000 for a course of treatment and extends life by an average of four months. Yervoy costs $120,000 for three-and-a-half months. Some patients live much longer, which fuels demand for the drugs. But others spend a lot and get little. Otis Brawley, chief medical officer for the American Cancer Society, calls the new treatments “the next frontier”, but adds: “We are not buying a lot of life prolongation with these drugs.”

Britain’s National Institute for Health and Clinical Excellence, a public body that judges whether medicine is cost-effective (ie, what Sarah Palin would call a “death panel”), has rejected several new cancer drugs. That so upset patients and tabloid editors that the British government back-tracked and created a separate fund to pay for expensive oncology drugs. The government now plans to introduce “value-based pricing” by 2014, with a system to price drugs not just for their efficacy but also for their “wider societal benefits”.

America does things differently. The government health programme for the elderly is barred from considering price at all when it decides whether to cover injected drugs under something called Medicare Part B. Under Part B’s loopy reimbursement system, the more a drug costs, the more the oncologist who prescribes it is paid. Patients have little reason to demand cheaper drugs. Part B usually covers 80% of a drug’s price, and most patients have additional insurance to cover the remainder. Americans hate to be denied any kind of treatment: a delay in Provenge’s approval prompted furious talk of rationing.

Private insurers have started to make patients pay a larger share of their drug bills. But drug companies often help to pay the patient’s share, which stops the public from getting angry about soaring costs. Even when prices are high, demand for cancer drugs is largely inelastic, says Tomas Philipson of the University of Chicago. Dying patients understandably place a high value on life, so they are willing to pay more for treatment. All this means that firms can charge steep prices. “At some point it’s just corporate chutzpah,” says Peter Bach of the Memorial Sloan-Kettering Cancer Centre in New York. “There’s no check in the system.”
America’s propensity to pay has one important benefit: it encourages investment in research. Drugmakers recoup their investments in America; other countries take a free ride. New research may yield better treatments. And today’s cancer drugs may prove more effective when tested in combination with others, predicts Todd Golub, director of the cancer programme at the Broad Institute, a genetics research laboratory.
Who will reform this unsustainable system? Private insurers may haggle harder. Patients may grow restive—a recent study found that 10% of cancer patients (not covered by Part B) fail to take prescribed drugs, largely because of the cost. Barack Obama’s reforms are supposed to cajole all health-care providers into becoming more cost-effective, but that will require political bravery to enforce, and few politicians are brave enough to do anything that sounds like rationing grandma’s cancer drugs. Congress recently authorised more than $1 billion to compare the efficacy of drugs—while explicitly ignoring their cost.

To view the original article CLICK HERE

I just want to say sorry for copping out at times and leaving Lee and friends to cope!
Any help and support YOU can give her will be hugely welcome.
I do make a lousy patient!

.
If YOU want to follow my fight against Cancer from when it started and I first presented with symptoms see The TAB just below the Header of this Blog. called >DIARY of Cancer< just click and it will give you a long list of the main events in chronological order.
.
Thoughts and comments will be in chronological order in the main blog and can be tracked in the >ARCHIVE< in the Right Sidebar. You may find the TABS >MEDICAL LINKS< and also >CANCER LINKS< of help.
.
YOU are welcome to call me if you believe I can help in ANY way.
.

Posted by: Greg Lance-Watkins
tel: 01291 – 62 65 62

17-Apr-2011 – Casual Reading AS YOU DO!! ‘CISPLATIN’

17-Apr-2011 – Casual Reading AS YOU DO!! ‘CISPLATIN’

A recent article in the Mich. State University Alumni magazine (Spring 2011)
talks about the late Dr. Barney Rosenberg who developed the anti-cancer drug
Cisplatin (Platinol) and used with carboplatin (Paraplatin)- these two drugs are
rarely used alone.

” They are key ingredients in many combinations of drugs,
radiation and surgery that make cancers survivable, according to the director of
clinical research of one of the world’s top cancer hospitals.

Cisplatin became the backbone of combination therapy for testicular,bladder,lung,ovarian,head and
neck,gastric cancers and recently for triple negative breast cancer and a number
of other less common tumors”

according to Bruce A. Chabner in Rosenberg’s obituary published in Cancer Research.

The MSU article further states
“Caplatin and oxaliplatin(developed in Japan) have further extended this range of benefit.

The patients cured by these regiments and those that have benefitted from this
therapy number in the millions.” Tumors of the kidney are included in the list
of cancers I found out.

& In Reply:

Cisplatin has been around a long time (1970″s) as a cancer treatment.
It is VERY toxic to the kidneys, causes neuropathy and hasn’t shown a great response rate in general for RCC-like 17%. But is usedsucessfully for sarcomas so it is more likely to be used for kidney cancer with sarcomoid features. http://annonc.oxfordjournals.org/content/13/1/116.full.pdf

I just want to say sorry for copping out at times and leaving Lee and friends to cope!
Any help and support YOU can give her will be hugely welcome.
I do make a lousy patient!

.
If YOU want to follow my fight against Cancer from when it started and I first presented with symptoms see The TAB just below the Header of this Blog. called >DIARY of Cancer< just click and it will give you a long list of the main events in chronological order.
.
Thoughts and comments will be in chronological order in the main blog and can be tracked in the >ARCHIVE< in the Right Sidebar.

You may find the TABS >MEDICAL LINKS< and also >CANCER LINKS< of help.
.
YOU are welcome to call me if you believe I can help in ANY way.
.

Posted by: Greg Lance-Watkins
tel: 01291 – 62 65 62

25-Aug-2008 – A CYNICAL LOOK AT The NHS

25-Aug-2008 – A CYNICAL LOOK AT The NHS

2008 August 25 01:13:35 BST
Posted By: Greg_L-W.
Discussion
Greg_L-W.’s Blog

Hi,

I’ve just put this on the Cancer Research comments section on their web site:
http://scienceblog.cancerresearchuk.org … comment-537

Quote: I HAVE THE ANSWER

May I suggest that if you are worried that you have or may get Kidney Cancer and need to claim on your Health Service:-
Make sure you are on a Government QUANGO the beauty of the job is that the Government doesn’t believe in the Health Service and provides all its senior staff with PRIVATE HEALTH INSURANCE!

Also the Government doesn’t believe in the Public Pension Service so it gives all its Staff prefferential INFLATION LINKED PENSIONS to compensate for the c*ck up they know they will make in Government.

Also Government staff on QUANGOs are not held accountable for mistakes just put all the data you can find on your provided Lap Top and lose it like the MoD do having lost over 700 to date!
If you want more expenses just loose your CD with all the records on them and claim for a larger sum.
Perhaps you have been away for the last month in Beijing with the other QUANGO members and 650 people funded from the public purse who had NO relevance to performing in the tedious and obscenely costly farce.

Join N.I.C.E. or a P.C.T. where you can be sure of no meaningful work, regular long holidays, inflation linked pensions, early retirement, stress related compensation, staff car schemes and of course PRIVATE HEALTH INSURANCE as of course you can’t relly on or trust the old NHS which is so badly managed it is obviously broken.

Don’t worry your job will be safe N.I.C.E. alone has a budget of £30,000,000 and if you need a pay rise you can take it out of the drug budget and kill off a few more Cancer Patients – they’re a nuisance anyway they just won’t die quietly they are just selfish – next they will start demonstrating but never mind the Government is on your side on a QHANGO so the State Police will be called in under the terrorism laws we can just murder them – woops sorry Mr. Menenez can we have those 8 bullets back!

Cover your risk – join a QUANGO.

The other beauty of a QUANGO or Government job is you get promoted for lies – look at Blair and his lies about Iraq which used so much of the money we could have used for health. Why do soldiers get health care? They knew the risks they should be like smokers or the obese and denied care!

Mandelson lied so often he is now an EU commissioner WITH PRIVATE HEALTH CARE!

On a £2.4Billion Budget I note incompetency and waste has already run that to £9.3Billion and it is rumoured the Olympics will cost Britain over £18,000,000,000 – Howmany people will the Government have to kill to pay for their tedious sport? Already they CLAIM that due to their incompetence they are going to have to kill Kidney Cancer patients!

Quick join a QUANGO and be safe for life.

Join me at http://www.KidneyCancerResource.com where we can fight this clearly non political issue!

First they came for the Jews but I was not a Jew so I did nothing….’

Regards and Warm Hands,
Greg L-W.

Have YOU commented? There are loads of ideas there!
Regards,
Greg L-W.

I just want to say sorry for copping out at times and leaving Lee and friends to cope!
Any help and support YOU can give her will be hugely welcome.
I do make a lousy patient!

.
If YOU want to follow my fight against Cancer from when it started and I first presented with symptoms see The TAB just below the Header of this Blog. called >DIARY of Cancer< just click and it will give you a long list of the main events in chronological order.
.
Thoughts and comments will be in chronological order in the main blog and can be tracked in the >ARCHIVE< in the Right Sidebar. You may find the TABS >MEDICAL LINKS< and also >CANCER LINKS< of help.
.
YOU are welcome to call me if you believe I can help in ANY way.
.

Posted by: Greg Lance-Watkins
tel: 01291 – 62 65 62