I was a resident (long ago) at the Memorial Hospital for Cancer and Allied Diseases, known to most as Sloan Kettering.
Back in the day, the attending oncologists gave the drugs, and the residents managed everything else. It was intense but I learned a lot. There was one cardiologist, one pulmonologist, one Intensivist, but we residents did most of the doctoring.
Everyone in my program went into heme-onc or ID. I chose ID because I thought H/O would be too sad.
I opened my first office in June of 1982, and in walked a Catholic priest who had been living in the West Village for seven years, short of breath and covered with KS.
I did almost nothing else for the next 20 years.
Anyway, drugs and money. One thing I learned was that someone with cancer who made it all the way to East 67th street, when counseled that the Phase I trial they came for offered a “one in a million“ chance of a good outcome would inevitably say, “no problem doc, I’m that guy” or some equivalent phrasing.
I always thought this gave the protocol guys kind of an unfair advantage.
Even though I never did Oncology, I was well educated in open questions circa 1975-79. It’s been really exciting to see many open questions become closed. From 1920-1997 the Chairman of. Surgery was always a breast surgeon. It’s telling that since 1997, it has been a prostate surgeon, because prostate issues are lagging 40 years ( at least) behind breast questions.
Why is the price only $480k per year? Why not $5 million per year? Seriously.
In other words, what are the factors that keep a check on the price. There must be some factors that prevent it from going to $5 million.
So identify those factors and leverage them more effectively. It is clear that the price is based on whatever the market (insurance companies and government/Medicare etc.) will bear.
Good luck with that. How about trying capitalism? Let the patients buy their medicines from Europe or India. (I’d eschew China.) the price would Trump like a rock. They got pretty good regulatory agencies in both those areas and $50,000 would be a lot better than 500,000.
absolutely Michael; be staunch; don't talk to them; reject them out of hand; who do they think they are?
Only slight fly in the ointment is that seemingly these wretched people make many of the drugs consumed in the US; still, I am sure marvellous US ingenuity will fix that double-time soon; with their fantastic AI developments, the US will roar ahead. Go the US!
I hear they were great at Fentanyl. and the folic acid study and CAD.? Just doesn't seem to work when western scientists do it on a western population. There a lot of places in the world who don't trust Chinese science, most of them their neighbors in Asia.
" There a lot of places in the world who don't trust Chinese science,"
absolutely Michael; absolutely;
for heaven's sake if you were to set foot in China; don't travel on any of their high-speed trains; don't travel on any of their extensive metro systems in their small cities; (eg Shenzen with population of 22 million has 17 lines with 421 stations.); or drive on the high bridges in Guizhou province; (tallest bridges in world); or fly in a Comac 919 if in China;
absolutely avoid these totally; only sensible thing to do;
If you want safe and reliable high-speed train travel, then trust US as the best; travel on the SF-LA high-speed line; a world beater. Best scientists, best technology.
The dodgy chinese science of making rare earth metal (REM) magnets too should be greatly doubted; avoid them totally; strange thing is Lockheed Martin (LM) badly want these rare earth metal magnets for radars in F-35s; but the chinese have an export ban; (LM cannot install radars in new jets as no radars can be built); so new F-35s have gym weights in the nose for balance); why on earth would Lockheed Martin trust chinese science; like you, I too am baffled. Rely on the best REMs: US made. the tops
You have a good point, that money drives the incentive to make new innovation in cancer drugs, and also, money drives the incentive to raise prices on drugs even with marginal benefits. I wish we had the ability to setup an authority that would evaluate the efficacy of drugs.
this video https://www.youtube.com/watch?v=RKs-33twRv8 describes how the US carefully spent perhaps $4 trillion on largely peaceful wars 2001-2026; in contrast, China frittered away $4 trillion building frivolities like high-speed rail; motorways; huge bridges; schools; electricity generation; couldn't they see the value the US was getting from blowing up endless things? The US has so much to show for it.
I was a resident (long ago) at the Memorial Hospital for Cancer and Allied Diseases, known to most as Sloan Kettering.
Back in the day, the attending oncologists gave the drugs, and the residents managed everything else. It was intense but I learned a lot. There was one cardiologist, one pulmonologist, one Intensivist, but we residents did most of the doctoring.
Everyone in my program went into heme-onc or ID. I chose ID because I thought H/O would be too sad.
I opened my first office in June of 1982, and in walked a Catholic priest who had been living in the West Village for seven years, short of breath and covered with KS.
I did almost nothing else for the next 20 years.
Anyway, drugs and money. One thing I learned was that someone with cancer who made it all the way to East 67th street, when counseled that the Phase I trial they came for offered a “one in a million“ chance of a good outcome would inevitably say, “no problem doc, I’m that guy” or some equivalent phrasing.
I always thought this gave the protocol guys kind of an unfair advantage.
Even though I never did Oncology, I was well educated in open questions circa 1975-79. It’s been really exciting to see many open questions become closed. From 1920-1997 the Chairman of. Surgery was always a breast surgeon. It’s telling that since 1997, it has been a prostate surgeon, because prostate issues are lagging 40 years ( at least) behind breast questions.
Why is the price only $480k per year? Why not $5 million per year? Seriously.
In other words, what are the factors that keep a check on the price. There must be some factors that prevent it from going to $5 million.
So identify those factors and leverage them more effectively. It is clear that the price is based on whatever the market (insurance companies and government/Medicare etc.) will bear.
Good luck with that. How about trying capitalism? Let the patients buy their medicines from Europe or India. (I’d eschew China.) the price would Trump like a rock. They got pretty good regulatory agencies in both those areas and $50,000 would be a lot better than 500,000.
" (I’d eschew China.)"
absolutely Michael; be staunch; don't talk to them; reject them out of hand; who do they think they are?
Only slight fly in the ointment is that seemingly these wretched people make many of the drugs consumed in the US; still, I am sure marvellous US ingenuity will fix that double-time soon; with their fantastic AI developments, the US will roar ahead. Go the US!
I hear they were great at Fentanyl. and the folic acid study and CAD.? Just doesn't seem to work when western scientists do it on a western population. There a lot of places in the world who don't trust Chinese science, most of them their neighbors in Asia.
" There a lot of places in the world who don't trust Chinese science,"
absolutely Michael; absolutely;
for heaven's sake if you were to set foot in China; don't travel on any of their high-speed trains; don't travel on any of their extensive metro systems in their small cities; (eg Shenzen with population of 22 million has 17 lines with 421 stations.); or drive on the high bridges in Guizhou province; (tallest bridges in world); or fly in a Comac 919 if in China;
absolutely avoid these totally; only sensible thing to do;
If you want safe and reliable high-speed train travel, then trust US as the best; travel on the SF-LA high-speed line; a world beater. Best scientists, best technology.
The dodgy chinese science of making rare earth metal (REM) magnets too should be greatly doubted; avoid them totally; strange thing is Lockheed Martin (LM) badly want these rare earth metal magnets for radars in F-35s; but the chinese have an export ban; (LM cannot install radars in new jets as no radars can be built); so new F-35s have gym weights in the nose for balance); why on earth would Lockheed Martin trust chinese science; like you, I too am baffled. Rely on the best REMs: US made. the tops
certainly nothing to do with need Vijay;
so Vinay: you say
"The price of a cancer drug had nothing to do with its mechanism of action-- whether new or next in class—
it was not related to how much longer it helped you live, and
ironically drugs that had merely been proven to shrink tumors cost more than drugs that extended survival."
so ............. embarrassed cough ............ can we ask? ...em ........ excuse me ..............
what is the price of a cancer drug related to?
I hear that in China an MRI for a visiting US tourist would be $70 whereas back in the good 'ol US, they would get an MRI for a bargain $2000
in the UK, it might be "free" on the NHS; but that would be after a 9-12 month wait
so? what is the price of a cancer drug related to?
Don't tell me it is related to corporate profits; I would never believe that one.
You have a good point, that money drives the incentive to make new innovation in cancer drugs, and also, money drives the incentive to raise prices on drugs even with marginal benefits. I wish we had the ability to setup an authority that would evaluate the efficacy of drugs.
this video https://www.youtube.com/watch?v=RKs-33twRv8 describes how the US carefully spent perhaps $4 trillion on largely peaceful wars 2001-2026; in contrast, China frittered away $4 trillion building frivolities like high-speed rail; motorways; huge bridges; schools; electricity generation; couldn't they see the value the US was getting from blowing up endless things? The US has so much to show for it.