A peep into the cancer industry. As usual it's all about money.

[Guest guest]

April 1, 2007

Op-Ed Contributor

Article - I (Two articles included)

Feeding the Cancer Machine

By SHANNON BROWNLEE

 

Annapolis, Md.

http://www.nytimes.com/2007/04/01/opinion/01brownlee.html?th & emc=th

HAVE you ever wondered why hospitals offer free cancer screening tests? You’ve heard the ads on radio, and seen them in newspapers, urging you to come to your local hospital for a free Pap smear, mammogram or prostate cancer blood test.

 

Hospitals would like you to think they are doing this out of the goodness of their hearts, that free cancer screening is a public service intended solely to improve your health. But there may be another motive at work here: providing free screening brings in new cancer patients, and cancer generates profits.

 

Has the profit motive gotten in the way of finding a cure for cancer or better treatment? Could it be that at least some of the $100 billion we spend each year on detecting and treating this disease is used not to improve the health of patients, but rather to prop up hospital finances?

Cancer makes money for hospitals in a couple of ways. First, it’s a disease of aging, and that means the majority of people who get it are covered by Medicare, which always pays its bills. Second, many treatments for cancer patients are particularly profitable, especially compared to those for other diseases.

 

Hospitals generally make money on surgery to remove cancer. Then there are all the imaging tests, like CT scans and M.R.I.’s, which are also well reimbursed by Medicare and other payers. The more cancer patients a hospital can attract, the faster it can recoup capital investments in imaging machines.

 

Another big source of profit is cancer drugs. Worldwide, we spend about $35 billion a year on chemotherapy and other drugs related to cancer treatment. Hospitals make money on drugs by purchasing wholesale and charging insurers full price. Cancer doctors also purchase drugs wholesale, making as much as two-thirds of their income on the “chemotherapy concession,” in which they sell and administer chemotherapy drugs in their offices.

 

Hospitals and doctors need to make money, of course, but the high profit margin in cancer has created a situation where providers have every reason to screen more people and treat those who are diagnosed with cancer more aggressively — and few incentives to hold back, even if that’s what the patient might prefer. Recognizing this, Medicare reduced its reimbursements for chemotherapy in 2005, but even with those changes, cancer remains an enormous economic engine in our health care system.

 

Sure, aggressive treatment is reducing mortality and improving the quality of life for some patients. Sometimes it even cures. But for many others, the cancer machine offers only marginal benefits at best, and providers push screening and aggressive treatment in part because they have nothing else to give, but also because it’s profitable. How much of the money we spend on unnecessary or futile cancer treatment might be put to better use searching for real advances?

 

 

Shannon Brownlee, a senior fellow at the New America Foundation, is the author of the forthcoming “Overtreated: Why Too Much Medicine Is Making Americans Sicker and Poorer.”

 

 

 

 

 

 

 

 

 

April 1, 2007

Op-Ed Contributor

Article - II

Patents Over Patients

By RALPH W. MOSS

 

State College, Pa.

http://www.nytimes.com/2007/04/01/opinion/01moss.html

WE could make faster progress against cancer by changing the way drugs are developed. In the current system, if a promising compound can’t be patented, it is highly unlikely ever to make it to market — no matter how well it performs in the laboratory. The development of new cancer drugs is crippled as a result.

 

The reason for this problem is that bringing a new drug to market is extremely expensive. In 2001, the estimated cost was $802 million; today it is approximately $1 billion. To ensure a healthy return on such staggering investments, drug companies seek to formulate new drugs in a way that guarantees watertight patents. In the meantime, cancer patients miss out on treatments that may be highly effective and less expensive to boot.

 

In 2004, Johns Hopkins researchers discovered that an off-the-shelf compound called 3-bromopyruvate could arrest the growth of liver cancer in rats. The results were dramatic; moreover, the investigators estimated that the cost to treat patients would be around 70 cents per day. Yet, three years later, no major drug company has shown interest in developing this drug for human use.

 

Early this year, another readily available industrial chemical, dichloroacetate, was found by researchers at the University of Alberta to shrink tumors in laboratory animals by up to 75 percent. However, as a university news release explained, dichloroacetate is not patentable, and the lead researcher is concerned that it may be difficult to find funding from private investors to test the chemical. So the university is soliciting public donations to finance a clinical trial.

 

The hormone melatonin, sold as an inexpensive food supplement in the United States, has repeatedly been shown to slow the growth of various cancers when used in conjunction with conventional treatments. Paolo Lissoni, an Italian oncologist, helped write more than 100 articles about this hormone and conducted numerous clinical trials. But when I visited him at his hospital in Monza in 2003, he was in deep despair over the pharmaceutical industry’s total lack of interest in his treatment approach. He has published nothing on the topic since then.

 

Potential anticancer drugs should be judged on their scientific merit, not on their patentability. One solution might be for the government to enlarge the Food and Drug Administration’s “orphan drug” program, which subsidizes the development of drugs for rare diseases. The definition of orphan drug could be expanded to include unpatentable agents that are scorned as unprofitable by pharmaceutical companies.

 

We need to foster a research and development environment in which anticancer activity is the main criterion for new drug development.

 

Ralph W. Moss writes a weekly online newsletter about cancer.

 

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