NOV 11, 2016

Rethinking the Benefits vs. Cost of Expensive New Cancer Drugs

WRITTEN BY: Xuan Pham
Unlike most fields of biology and science that’s suffering from lack of funding, cancer research is a booming business. Mark Zuckerberg, founder of Facebook, recently announced a $3 billion initiative to cure human diseases – chief among them is cancer. Sean Parker, cofounder of Napster, committed $250 million to developing new cancer treatments. And a coalition of philanthropists led by Michael Bloomberg is adding another $100 million to the cancer research pot.
 

But despite huge financial investments in cancer research, some studies find that new cancer drugs approved in the last decade have only improved survival marginally. This poses serious ethical concerns for Peter Wise, a bioethicist who voiced his opinions in a BMJ article.
 
For Wise, expensive new drugs that prolong survival by one or two months does not quite justify the increasing cancer costs to the patient and the healthcare system. And perhaps, at the end of the day, it’s the pharmaceutical companies that make the biggest profit with these new drugs, not the patients. Indeed, in 2015 alone, global sales of cancer drugs topped $150 billion dollars.
 
"The approval of drugs with such small survival benefits raises ethical questions, including whether recipients are aware of the drugs' limited benefits, whether the high cost to benefit ratios are justified, and whether trials are providing the right information," Wise wrote.
 


Importantly, the article is not a complete dismissal of the value of cancer research. Wise noted that the five-year survival mark has increased from 49 percent to 68 percent in the past four decades. This jump in survival surely would not have been possible without the treatment advances in this time.
 
But Wise argues that the improvement in cancer survival may not all be due to new drugs. Other factors, such as better education, changing lifestyles, improved screening and prevention measures may have also contributed to the fight against cancer.
 
Wise also brings up potential patient misinformation with every new cancer drug. Yes, new drugs bring hope and excitement to cancer patients, but Wise cautions against leading patients to have unrealistic expectations with new drugs.

"Good cancer care demands empowerment of patients with accurate, impartial information followed by genuinely informed consent in both the clinical trial and therapeutic settings," Wise wrote. "Ethical impediments to sound practice need to be addressed and corrected."

"Above all, the threshold for approval of new and existing cancer drugs needs to be raised - using more meaningful disease specific criteria of risk-benefit and cost-benefit," he concluded.
 
Additional sources: MNT