There’s an incredibly interesting Q&A in today’s Wall Street Journal with Arthur D. Levinson, the CEO of biotech pioneer Genentech, mostly concerning the topic of the company’s cancer drugs. (There is a lot of interesting cancer news in the papers these days, mainly because of the annual meeting of the American Society of Clinical Oncology in Chicago.)
Levinson regularly deals with complaints about the expense of certain cancer drugs. (There is a larger issue to be discussed here: why it’s medically and socially acceptable to spend so much money to extend life by only a few months — but that is a discussion for another time.) Here is something he said that, while certainly a defense of his own company, also presents an intriguing way of costing out the amount we spend on cancer medicine:
You don’t just crank these drugs out. My lab cloned a portion of the breast-cancer gene in 1982. And we started making antibodies to it in the mid-’80s. Then we got cell-culture results in the late ’80s and by the early ’90s we were getting animal results. And then approval was in December ’98. So this goes back a long, long time. Unless these companies can get a return, we are not going to get the new medicines that are making such a difference to patients’ lives right now.
There’s another way to look at it — look at how much society is investing in cancer. In the absence of better care, 42% of everybody out there is going to get cancer. And half of those 42% are going to die of cancer. It’s the leading cause of death among Americans under age 85. So how much are we spending on drugs for cancer? We have a $12 trillion GDP [gross domestic product]. And we’re spending $15 billion. If I do that math, 1/800th of GDP for the leading cause of death. And people say cancer drugs are bankrupting America! Give me a break.
Keep in mind that the reason that “42% are going to die of cancer” is, in a twisted way, good news: many people are living long enough to die of cancer thanks to improvements in treating heart disease and stroke. That said, Levinson makes his point forcefully. The Journal is also hosting a discussion forum on the topic of drug costs.
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There is a larger issue to be discussed here: why it’s medically and socially acceptable to spend so much money to extend life by only a few months — but that is a discussion for another time
Dr. Levinson says in the interview that some patients have been on Avastin (the $55K/year drug under discussion) for a “very long time.” While spending huge amounts of money prolonging life for a few months or weeks is a major issue, it doesn’t look as if Avastin’s effectiveness is so limited.
There is a larger issue to be discussed here: why it’s medically and socially acceptable to spend so much money to extend life by only a few months – but that is a discussion for another time
Dr. Levinson says in the interview that some patients have been on Avastin (the $55K/year drug under discussion) for a “very long time.” While spending huge amounts of money prolonging life for a few months or weeks is a major issue, it doesn’t look as if Avastin’s effectiveness is so limited.
The cancer issue raises a larger one in my mind. By prolonging life we are increasing the population and demand for food, this in turn is raising the “price” of food and probably increasing the rate of starvation in third world populations. Although this issue may seem to stretch things a bit (the conversion of corn to ethanol does not), the point is that some of our improvements are obtained by measuring the impact on a subset of the human population, not the entire population(or measuring them for a limited time and getting transient effects rather than steady state averages).
That’s like measuring the improvements in travel time that occur by making one lane of a freeway a high occupancy lane. The travel times, measured in that lane improve, but the average travel time for all lanes (including the high occupancy lane)get worse.
The cancer issue raises a larger one in my mind. By prolonging life we are increasing the population and demand for food, this in turn is raising the “price” of food and probably increasing the rate of starvation in third world populations. Although this issue may seem to stretch things a bit (the conversion of corn to ethanol does not), the point is that some of our improvements are obtained by measuring the impact on a subset of the human population, not the entire population(or measuring them for a limited time and getting transient effects rather than steady state averages).
That’s like measuring the improvements in travel time that occur by making one lane of a freeway a high occupancy lane. The travel times, measured in that lane improve, but the average travel time for all lanes (including the high occupancy lane)get worse.
@#2
“The cancer issue raises a larger one in my mind. By prolonging life we are increasing the population and demand for food, this in turn is raising the “price” of food and probably increasing the rate of starvation in third world populations.”
Never fear, Irish babies are still a cheap source of nutrition.
@#2
“The cancer issue raises a larger one in my mind. By prolonging life we are increasing the population and demand for food, this in turn is raising the “price” of food and probably increasing the rate of starvation in third world populations.”
Never fear, Irish babies are still a cheap source of nutrition.
Although I don’t necessarily agree with Levison’s justification, I don’t really think he should be under such fierce attack either.
Drug companies don’t have any more social responsibility to provide cheap meds for cancer patients then grocery stores have to provide discounted food for the hungry.
There might be instances of companies in both industries doing so, but I don’t think there is any obligation to do so. It would be nice.
Eventually, market forces will combine to make those drugs cheaper. Generic brands, public outcry and a few other factors will suddenly make it a good idea. Until then, why should they?
Although I don’t necessarily agree with Levison’s justification, I don’t really think he should be under such fierce attack either.
Drug companies don’t have any more social responsibility to provide cheap meds for cancer patients then grocery stores have to provide discounted food for the hungry.
There might be instances of companies in both industries doing so, but I don’t think there is any obligation to do so. It would be nice.
Eventually, market forces will combine to make those drugs cheaper. Generic brands, public outcry and a few other factors will suddenly make it a good idea. Until then, why should they?