, , ,

By Megan Cooley

Megan CooleyAyalew Tefferi, M.D., a hematologist from the Mayo Clinic, was interviewed recently regarding the physicians’ struggle to help their cancer patients gain access, affordable access, to treatments amidst the ever-increasing drug prices. You may have read on the AAPS Blog the recent series of posts 50 Shades of Cancer, showcasing the multitude of candidate drugs available to patients. It’s true: there are more treatments available now to cancer patients than ever before. But what good are they if they are not accessible to patients?

Tefferi stated that many of his cancer patients, especially those in late stages, either incur tremendous debt to gain a few months of life, jeopardizing their retirements, or they decline further treatment because the costs don’t outweigh the benefits. In one of the wealthiest countries in the world, access to affordable healthcare should not be such a financial burden on patients and their families. The United States has one of the strongest bases for innovation and discovery. The amount of knowledge and the development that pours out of universities, research institutions, and pharmaceutical industries is immense. So is it really fair that access to cancer treatments can cost a middle-income family at least half its annual income?

Tefferi places some of the blame on the pharmaceutical industry: businesses being in it for themselves, etc. We have all heard this and generally do point the finger at the industries. But it’s important to always keep in mind the total process that is involved in bringing a drug from the bench to the patient. This process can take a decade or more to reach patients! Years are spent in development and testing in the lab before drugs even enter clinical trials. Most companies have invested millions of dollars by the time a drug reaches clinical trials. Then there are at least three phases for trials, which cost money as well. Then there is the ever-looming Food and Drug Administration (FDA) approval, assuming the drug even makes it out of trials, and most don’t.

One of the ways patient costs could be reduced is by lifting some of the restrictions imposed by FDA that trickle down to the pharmaceutical companies. FDA has already implemented a program to encourage accelerated drug development, Expedited Programs for Serious Conditions—Drugs and Biologics (PDF), although it is unclear whether such programs benefit pharma financially.

Perhaps we should also let patients have more access to candidate drugs that aren’t in trials yet but have shown success in animal testing, at a reduced rate or no cost. Pharma gets their candidate drugs into patient hands faster and consequently benefit can be determined sooner. This would curb the number of drugs that enter clinical trials and make the most promising candidates, those that show both potential in animal and human, the treatments that are further pursued.

Lastly, I think it is important to keep in mind that patients today are not the same as patients 30 or even 20 years ago. Patients have the Internet at their fingertips, which makes the patients more educated about their disease and what treatment options are available. Patients have more of a voice now in their care than they ever have had before. Let them take that active role by providing them with more than the standard options currently available and offering them options that don’t overburden them financially to the point that they choose their death.

Megan Cooley, Ph.D., is a postdoctoral fellow at the University of Kansas Medical Center. Her research is focused on understanding the effects of the tumor microenvironment on acquired chemoresistance and metastasis.