Author: George Weiner
Date: 2017-01-06 18:20:20

Vice President Biden spoke recently about how he will spend his time when he leaves government in a few weeks. The “Cancer Moonshot” will be behind him, but his dedication to the cause of reducing the burden of cancer will not. Through his Cancer Moonshot, he has spoken with passion and eloquence about the importance of breaking down cancer research silos that limit our ability to share information about the genetics of cancer.  He has challenged us to change our culture and develop new collaborative models for cancer research.

He also expressed concerns about the economics of cancer therapy. More specifically, as we develop better cancer therapeutics, can we afford them? This is one of the items he will address when his term as Vice President comes to an end.

The cost of cancer drugs is breaking the bank.  Combinations of cancer medicines are going to be the wave of the future – and if nothing changes, the cost of the most effective new cancer treatment combinations could top $250,000/year.  This is unsustainable. In looking at this complex issue, let’s start with the basics where there is general agreement:

• We need new, more effective, less toxic cancer medicines.
• Cancer research has progressed to the point where such medicines are within reach.
• We are willing to invest in research to bring these medicines forward. Although such research is expensive, as a society we are willing to pay the price.
• Once a cancer medicine has been identified, the research completed, and the indications for the new cancer medicine’s use established, the cost of manufacturing most cancer medicines is relatively low.

In other words, the vast majority of the societal cost for cancer medicines is expended up front in research and development. Once cancer medicines are identified, the cost of scaling up manufacturing so we can provide these medicines to all patients who might benefit from them is modest. Given these simple and undeniable facts, the current industry approach of managing the cost of cancer medicines after they have been developed by limiting access and rationing their availability makes no sense at all.

Vice President Biden, in his cancer moonshot efforts, called the cancer research community to task (and appropriately so) for a culture that resulted in researchers working in silos and not doing enough to share their research results. At Holden, we have taken Vice President Biden’s charge to heart and are working collaboratively with other cancer centers to explore new ways to share cancer research information with the goal of accelerating progress in cancer research (more on this in future blogs).

A similar message to change culture and break down silos is needed when it comes to addressing the cost of cancer medicines.  As a society, we have already paid the research and development costs for new cancer treatments. It is irrational to control costs by only allowing those cancer patients with the deepest pockets or the best insurance access to the silo containing the newest and best cancer medicines.

While the problem is clear, the solution is not.  I will remain engaged and supportive as Joe Biden adjusts from being Vice President to being a private citizen and brings his passion and high profile to finding ways to break down yet another set of silos.