Jimmy Carter’s Breathrough Therapy
Jimmy Carter announced over the weekend that, after just seven months, he’s no longer receiving treatment for melanoma that had spread to his brain.
The former president’s treatment included a round of targeted radiation for several brain tumors and doses of Keytruda, a newly approved immune-boosting drug that helps the body seek out and destroy cancer cells.
“Medical experts have called Keytruda and similar immune therapy drugs “game-changing” for patients with melanoma,” the Associated Press’ Kathleen Foody explains.
Carter’s breakthrough therapy can be given in 30 minutes with no nausea side effect. So he can take this treatment, and it can enhance his life. That is why the FDA gives accelerated approvals. We need more of them. Because the drug is so new, doctors are still learning the best course of treatment for each patient.
“Some people believe they should be continued as long as a patient is doing well, some feel the drugs should continue for a period of time and then be stopped,” Dr. Len Lichtenfeld, deputy chief medical officer for the American Cancer Society, told the Associated Press. “This is clearly a (decision) based on individual evidence specific to the president and made with his doctors.”
At a time when America’s health care conversation has stalled somewhat, Carter’s breakthrough offers a chance to break through the noise. We need to step back from the superficial back-and-forth about drug pricing and develop a deeper conversation about the spectrum of needs that patients have, how best to meet them and the ways that everybody can contribute.
A Tale of Two Headlines
With new research from a partnership by MIT, Harvard University and University College London, Newsweek optimistically writes that “Scientists may have found cancer’s Achilles’ heel.”
Researchers have been able to find “unique markings within a cancerous tumor that they believe could allow the body’s immune system to target the disease.”
“What we’ve found for the first time is that tumors essentially sow the seeds of their own destruction,” Charles Swanton, a cancer expert who led the study, told The Guardian. “And that within tumors, there are immune cells that recognize those flags which are present in every tumor cell.”
This research is very promising, but we’d like to caution that these headlines over-simplify the story. We need health journalists to move away from the typical “cure for cancer” narrative.
Conversely, researchers may need to work on their side to better explain the advanced scientific terms to patients and the general public. For comparison, the headline in the journal Science from which the Newsweek story is based, “Clonal neoantigens elicit T cell immunoreactivity and sensitivity to immune checkpoint blockade.”
Perhaps that middle ground is best demonstrated by the University College London’s Cancer Institute, which explained the research as “Tumours contain the seeds of their own destruction.”
“The body’s immune system acts as the police trying to tackle cancer, the criminals,” said Dr Sergio Quezada, co-author of the study and head of the Immune Regulation and Cancer Immunotherapy lab at UCL Cancer Institute. “Genetically diverse tumours are like a gang of hoodlums involved in different crimes – from robbery to smuggling. And the immune system struggles to keep on top of the cancer – just as it’s difficult for police when there’s so much going on.”
Value-Based Pricing
Ivan Oransky, Vice-President and Global Editorial Director of MedPage Today, recently posted an interview with Christi Shaw, president of Novartis Pharmaceuticals Corporation.
The entire exchange is worth a quick read. We’ve written before about how Novartis is trying to alter the payment paradigm by adopting a “pay-for-performance” policy with the drug Entresto. The treatment helps decrease heart-failure–related hospitalizations. One point made by Shaw that stood out to us: the substantial bureaucratic headaches that faced Entresto:
“Unfortunately when physicians tried to prescribe, they found that there is massive paperwork, prior auths, one physician was telling me how many times they had to write a prior auth, or an exception and then they had to get on the phone with the medical people which they don’t have time to do that. When they see a patient every 7 or 11 minutes, your audience knows this, there’s not a lot of time.”
Fact Check 2016: Clinton’s Drug Price Distortion
Fortune’s Jen Wieczner dismantles presumptive Democratic nominee Hillary Clinton’s latest campaign ad, which targets the cost of prescription drugs. Clinton’s ad targets a drug that, according to Clinton, costs $14,700 for a refill. “This is predatory pricing,” Clinton says. “And we’re going to make sure it is stopped.”
But, Wieczner points out that “the predatory price gouging that Clinton references in the ad has already been stopped.”
“You can currently get the same 10-vial package referenced by Clinton for just $104 at Walmart,” Wieczner explains. “Contrary to Clinton’s assertion that the patient ‘has to take a brand-name drug,’ the patient has for the last 16 years had the option to take a much cheaper generic version of it. In fact, the drug—now manufactured generically by Perrigo—may cost even less today than it did back in 1980.”
Here’s the kicker: the drug company offered to help the patient.
“Valeant, for example, said it approached the patient in the ad after being made aware of her situation earlier this winter, and offered her payment assistance. She apparently declined, saying she wasn’t bothered much by the price increase because her insurance plan covered the drug anyway, according to the version of events that Valeant posted on its website Tuesday.”