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A cancer trial’s unexpected result: Remission in every patient

nytimes.com

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Re: A cancer trial’s unexpected result: Remission in every patient

#111

Post by bearjaws »

MontagFTB wrote: post #9

> The medication was given every three weeks for six months and cost about $11,000 per dose. That’s an $88,000 treatment for the medication alone. Given the apparent success of the drug, is it expected for the price to drop as the volume of patients spike?

Chemotherapy for 3-4 months is around $200,000 - $400,000.

You will not see a price reduction, if it doesn't require chemotherapy or significantly reduces the number of rounds of chemotherapy, this drug will cost $150k+ for full treatment.

All of this assumes side effects are better than chemotherapy. Given chemotherapy care plans are some of the most arduous, it will be hard to be worse than chemo.

Re: A cancer trial’s unexpected result: Remission in every patient

#112

Post by zzzeek »

pc86 wrote: post #89
zzzeek wrote: post #32

My dad was fortunate enough to get into a trial at Sloan for Obinutuzumab for Chronic Lymphocytic Leukemia. At the moment, after 6 weeks of treatment, the percent of cancerous cells in his bone marrow has gone from 95% to 5%. The treatment was very intense as it overloads the kidneys on the first few treatments due to the dramatic amount of cells being flushed out. This is a cancer for which there was not much treatm…

Probably a decade ago a friend of mine passed from Acute Lymphocytic Leukemia in his 20s. I'm not sure what the differences are between ALL and CLL (other than knowing the differences between acute and chronic in a more general sense of course) but glad to see they are making at least some progress.

the chronic form is often written off when first diagnosed as "it will never affect you" - it can take decades to cause bigger problems. Dad's 80 and it's been causing bigger problems for some years. It would be surprising if there aren't new treatments for the acute form you mention as well.

Re: A cancer trial’s unexpected result: Remission in every patient

#113

Post by saiya-jin »

Merad wrote: post #68
spywaregorilla wrote: post #31

Earlier quoted context omitted.

I'd rather just die. Throw a party. Tell my kids they're getting a ton of cash. Say good bye on happy terms. Vs. a miserable decay for everyone involved at huge expense. It's not worth it. Forget the money. The emotional toll is large and for whose benefit?

Even ignoring the fact that human euthanasia is illegal in most of the US, it's rarely that easy. Both of my paternal grandparents lived into their 90s but suffered from mental decline (different forms of dementia) and died as shells of their former selves. If you could have spoke to either of them at the end of their lives but with their full mental capacity, I suspect they would have said that they'd have preferred…

It really, really doesnt have to be that complex. If people are religious nuts to believe suicide would bring them to some religion's hell (it won't, since it doesn't exist even if their variant of god(s) would exist), there are tons of ways to pass out rather quickly and not fulfill that criteria, and not bother anybody with the process (various car/train jumpers or suicide-by-cop doers whom I consider utter selfish a-holes).

Walk out to a storm or blizzard not equipped for it. Go fight a bear or lion or crocodile. Go for a swim that you can't come back from. Do some high risk type of adventure that in high age is not even discussed. If you make it, great experience, move to next one.

The list is literally endless and can be done in some form even by quadriplegics. It allows you to plan goodbye and closures, wills etc. The fear and pain and suffering is concentrated into such a tiny sliver of time compared to dying discussed its uncomparable.

It just takes balls to accept that this is it, what mattered for you in life is over, and now its time to think about your closest ones and not yourself. Like a breakup, many will continue living in bad relationship since its a small amount of pain and evil every hour, every day. Instead of standing up and walking off to uncertainty and freedom.

Re: A cancer trial’s unexpected result: Remission in every patient

#114

Post by mattmaroon »

MontagFTB wrote: post #9

> The medication was given every three weeks for six months and cost about $11,000 per dose. That’s an $88,000 treatment for the medication alone. Given the apparent success of the drug, is it expected for the price to drop as the volume of patients spike?

Generally drugs that cure a condition cost MORE than the pre-existing treatments while under patent protection with no viable competitors. There’s only one source and you’d rather cure the disease with a pill so you’ll pay more.

Market dynamics don’t come into play when there’s only one. If competitors appear or after patents expire it may get cheap, but the cost early on will have no relation at all to production costs.

Re: A cancer trial’s unexpected result: Remission in every patient

#115

Post by mmcnl »

There are many articles like this every year. I understand there's no silver bullet for curing cancer, but I am interested in the actual results of new treatments instead of the potential of new treatments, which seems to attract way more headlines.

Is there an overview somewhere of new treatments over the years, and their effect? What is the progress we have made?

Re: A cancer trial’s unexpected result: Remission in every patient

#116

Post by bsder »

xiphias2 wrote: post #48

This experiment of treating cancer with checkpoint inhibitors before chemotherapy should be widened to all cancers where the CI is available and effective as soon as possible, as it can cure lots of lives. I'm worried that it will take many years until that happens.

> I'm worried that it will take many years until that happens.

For good reason. If we detect cancers early, surgery and radiation are often very good nowadays--often allowing you to skip chemotherapy. And these are far less likely to kill the patient than a checkpoint inhibitor (which can overload your kidneys if it works or give you autoimmune diseases even if it doesn't).

The problem is that there are a lot of cancers we don't detect early-lobular breast cancer, pancreatic cancer, etc. And for things like intestinal cancers radiation is particularly bad.

These kinds of immune treatments are likely to get promoted first line treatments quickly if they really are this good--especially since they are likely to work on stage 4 metastatic cancers for which we don't have anything decent.

Re: A cancer trial’s unexpected result: Remission in every patient

#117

Post by jlarocco »

brigandish wrote: post #42
klyrs wrote: post #29

Earlier quoted context omitted.

I met a researcher once who was doing what appeared to be groundbreaking research on cancer care. He had this beautiful, tear-jerker story about losing his wife that cast a rosy, altruistic hue on his research. When he was asked what the device would cost, he cheerily replied "whatever the market will bear." That's always stuck with me -- the problem with American healthcare is the American interpretation of capitali…

> That's always stuck with me -- the problem with American healthcare is the American interpretation of capitalism. What should it cost instead? > Dude was living off of government research grants. Let's imagine his work comes to fruition. The drug is expensive but efficacious - is this not a good thing? Should the government have not helped fund this drug because now it's expensive? The alternative is a world withou…

> Should the government have not helped fund this drug because now it's expensive?

If he wants to charge "what the market will bear," then he should fund the research through the market.

If he wants government handouts to do the research then the public deserves to get the benefit that it's paying for - we're not funding it to make some guy rich.

I'm not saying it should be free, but he's already opted out of the market, so he loses out on market pricing. Manufacturing cost plus some reasonable percentage for the creator.

Re: A cancer trial’s unexpected result: Remission in every patient

#118

Post by gruez »

bearjaws wrote: post #111
MontagFTB wrote: post #9

> The medication was given every three weeks for six months and cost about $11,000 per dose. That’s an $88,000 treatment for the medication alone. Given the apparent success of the drug, is it expected for the price to drop as the volume of patients spike?

Chemotherapy for 3-4 months is around $200,000 - $400,000. You will not see a price reduction, if it doesn't require chemotherapy or significantly reduces the number of rounds of chemotherapy, this drug will cost $150k+ for full treatment. All of this assumes side effects are better than chemotherapy. Given chemotherapy care plans are some of the most arduous, it will be hard to be worse than chemo.

> Chemotherapy for 3-4 months is around $200,000 - $400,000.

Is that the american price or the "other developed countries" price?

Re: A cancer trial’s unexpected result: Remission in every patient

#119

Post by greedo »

horsawlarway wrote: post #27
ta988 wrote: post #22

Earlier quoted context omitted.

Is that the real price of a nursing home in the US? Who can afford that?

Yes - that's not unreasonable for a full time care facility for something like dementia or Alzheimer's in the US (it's below what we paid for my grandmothers). If you're lucky - they have long term care insurance, and that covers most of the expenses for approx 2 to 10 years (depending on how old the insurance is - it's getting harder to find long plans, and they're all getting significantly more expensive as it turn…

"Otherwise... you spend everything, and then your kids pay."

That's incorrect. With Medicaid, the recipient is require to spend down their assets to a small amount, then Medicaid will pick up the remainder. The recipient's children aren't on the hook for anything. Of course, they won't receive any inheritance since the estate of the recipient has been drained prior to Medicaid.

Re: A cancer trial’s unexpected result: Remission in every patient

#120

Post by sirsinsalot »

Gordonjcp wrote: post #92
MauroIksem wrote: post #33

Earlier quoted context omitted.

It's cheaper than other chemos..my mom has breast cancer and her chemo according to insurance cost 65k per infusion every 3 weeks.

That's *insane*. Here in Scotland each dose costs the NHS at most a couple of hundred quid, plus about that again to administer. None of that is paid by the patient.

It is crazy what the incentives do in the US.

It is a bit like car insurance here, which keeps rising because insurance companies keep edging the cost of a claim upwards (courtesy cars at extortionate rates, repair, ...) because there's no insentive to keep costs down or not profiteer.

With the NHS's buying power for drugs, they can get a little bit nearer a sensible margin from the supplier rather than the insane US costs underwritten by inflationary insurance.

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