Expensive, but modestly useful new cancer drugs: What to do?

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cancer-cellDid the pharmaceutical industry paint itself into a corner this time? Maybe yes.

According to an article that appeared in FiercePharma, one of the premier websites covering the drug industry, the recent, radical change in the strategy of the drug industry out of traditional disease areas and into oncology may have backfired.

A record 11 oncology drugs were approved in 2012, but most of them offered only modest benefits, as measured by survival and disease-free progression times, but with a huge price tag typically $100 thousand per year.

And it looks like companies may have pushed a little too hard. As of now, 80 percent of U.S. insurance companies do not plan to cover these drugs at least until there is some evidence of an actual cost benefit, most likely measured by lives saved rather than other parameters, such as progression-free disease a far less important factor.

ACSH s Dr. Josh Bloom wrote an op-ed in last month s New York Post, entitled Searching for the wrong miracles where he argued that this was going to become a real issue, especially since the shift into oncology necessitated a shift out of other areas, for example, antibiotic research.

But to conclude that companies are purposefully putting out suboptimal cancer drugs strictly for revenue is incorrect.

Derek Lowe, creator of the widely-read In the Pipeline blog was quoted in the Post op-ed, and he sums it up perfectly: It s not like we re trying to find something that just extends a cancer patient s life by four months. Rather, we try all these mechanisms that look, biologically, like they might really work. It s just that cancers are too heterogeneous and unstable they mutate their way around a lot of our good ideas, and the cells that remain roar back in an untreatable form.

This is a tricky situation. If the new generation of cancer drugs represented a groundbreaking advance, it would be essential that patients had access to them.

But according to Dr. Bloom, The benefits of the new drugs are mostly modest and the prices are very high. This makes for some difficult but intriguing economic and ethical issues, which will need to be addressed. I don t see any clear answer to this anytime soon.