Friday, September 5, 2014

When You Are Already A Terminal Case, What Would Three Years Of Cancer Free Living Be Worth?

This is -- to be fair -- all the data we have. It does seem possible -- likely even perhaps -- that many many of these formerly end-stage cancer patients will experience a decade or more of cancer-free life. The clinical trials just haven't run their course yet.

I honestly don't know that we (as a matter of public policy) should rush to complain about the price attached to that sort of an outcome, for potentially hundreds of thousands of cases. Biologics are extremely tricky to manufacture in quantity, and the R&D involved -- in getting the anti PD-1 immuno-oncology candidates to this moment of first approvals -- was vast, and is ongoing (and the expenditures are still accelerating -- as more and more clinical trials, for other cancers, are launched).

And so, I (for one) won't immediately complain about the $184,000/year cost for BMS's Opdivo® -- nor about the indicated $150,000/year cost of Keytruda®. [Similarly, I am pretty sure Sovaldi® is a reasonably fair price (all things considered), at $84,000 -- as a cure for Hep C.]

Back to the central point: do I wish that potential cures for many forms of high-burden cancers could be manufactured and sold nearly for free?

Of course I do. But we all know that is a near impossibility. The prices must reflect at least a recoupment of the cost of the effort, and in fairness ought to be measured against the societal cost of not having the new therapy available. Now, the point of my little narrative: do I think this is some form of price gouging? Not at all. And this, from a deeply avowed skeptic -- about the value of pharma's marketing efforts.

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