byteCoder 91 days ago [-]
I’m now 5.5 years post-treatment with immunotherapy for Stage IV melanoma and have had no evidence of disease for over four years. When immunotherapy works, it can be impressive.

For me, my treatment (adoptive cell therapy using tumor infiltrating lymphocytes) used my own white blood cells (130 billion in lab-selected and expanded form) to overwhelm the mutated cancer cells.

It was a one-time treatment (over 3-4 weeks in the hospital) with no further meds or other treatments required.

Immunotherapy has become an important tool in the future of fighting cancer, for sure.

SteveNuts 91 days ago [-]
What was the treatment like? I've heard it's similar to having the worst flu of your life * 1000.
wbl 91 days ago [-]
He has a life. Melanoma is insanely deadly and painful.
byteCoder 91 days ago [-]
Yes, the treatment was obviously totally worth it. And, I'm extremely grateful for being in the lucky 30% of patients who response completely to it.
byteCoder 91 days ago [-]
Yes, for the two days of high dose IL-2 every 8 hours, it was pretty bad. My experience was limited to nausea, fever, sweating, and bed-shaking rigors. I've heard that some patients experience hallucinations.

Note: IL-2 was administered after I received my lab-grown white blood cells. It acts as signal to one's immune system to activate. It was used to jumpstart my immune system after it had been replaced.

bengarrr 91 days ago [-]
I wonder how a combination of aggressive immunotherapy and "sickness" counteracting effects of cannabis (for the nausea, fever, sweating) would do in making the immunothrerapy more effective and tolerable.
byteCoder 91 days ago [-]
Since the treatment was performed on site at the National Institutes of Health using Federal research dollars, this wouldn't have been an option. So, I have no idea.
homero 91 days ago [-]
Was there an option to be sedated? I wouldn't handle fever and shaking that bad, I'd panic.

Also I don't think I'd be eligible, I have ulcerative colitis which is autoimmune.

eecc 91 days ago [-]
That’s great news both for you and for all of us.

I hope all patients that would benefit from this treatment will have access to it, to save their lives and to validate and improve the therapy for all those to come

byteCoder 91 days ago [-]
Yes, harnessing the patient's immune system to fight their cancer is a very promising technology and is saving the lives of many patients, even more as the processes and meds get further refined.
marckemil 91 days ago [-]
I'm a radiation oncologist specializing in lung cancer. Here's my take:

Immunotherapy is really revolutionizing the treatment of locally advanced and metastatic lung cancer. However, a "revolution" in our world is improving 5-year survival by 10-15% in absolute value. It's not outstanding, but when your baseline is around 10%, improving it by 10% means doubling it. That's why immunotherapy is being adopted so quickly despite its price.

A poster mentioned $100 000 is not a lot if it adds 10 years. It's not as simple. Right now we don't really know if we can stop the treatment. So people often receive the treatment until they progress. If it's 4 years, we're looking at $400k... The cost on society in general will have to be dealt with (and debated) at some point. I doubt insurance companies will continue paying for those treatments "forever", especially considering how prevalent lung cancer is.

Immunotherapy benefits from a great "romantic" story, which helps with its marketing like no other drug. It's your own immune system, your army, waking up and attacking the greatest villain of all; cancer. The alternative, chemotherapy, is often seen as poison. Granted, it has fewer side effects, but it has some, and they can be nasty. Basically, the immune system is in a constant state of equilibrium. You stimulate it too much and it starts attacking your own body. We're seeing some cases of thyroid problems, lung inflammation (pneumonitis), skin problems... Generally speaking though, it's better than most chemos.

Overall, it’s a great treatment but obviously not perfect, crazy expensive to a point that it’s likely not sustainable in the long run. Despite all of the drawbacks, it’s a really exciting time for oncologists as we can finally offer more hope to our lung cancer patients.

shadowtree 91 days ago [-]
This is truly exciting and only just the beginning.

There is a host of bio-tech startups following this initial wave - with two main goals:

1., Improve the treatments to become 100% cures

2., Lower the price

This is very similar to tech and, say, the storage space. Went from 100k for a few GBs to peanuts for TBs on AWS pretty quickly. That's what momentum in a crowded space will do.

Healthcare systems around the globe will have to figure out the effects of this, similar to autonomous driving. And it is not just simple cost of treatment.

What if cancer becomes curable? What to do with all the cancer wards? Specialists in Oncology? Chemo/Radio/Surgery? The spider-web effect here is gigantic.

Sticker price for the drug vs. long term treatment (multiple chemo rounds, surgery, palliative care) if its 100k is NOTHING.

randcraw 91 days ago [-]
Yes, this news is exciting. But right now we're a very long way from curing cancer.

In 50% of the full range of cancer types treated so far by the drug in question, immunotherapy does absolutely nothing. And for another 25% it helps only a little. Only about 25% see a game-changing response. Even then, among high responders, most are not cured. They do live longer than if treated only with chemo. (In this study announcement, there's a 51% better survival rate after one year. That's great for those who are near death. But it offers them additional months of life, not decades.)

As of today, the fraction of patients who are fully cured of cancer by immunotherapy is unhappily small. It's also important to remember that these therapies are too new for us to know how long the positive effects will last. Will the lucky ones add months or years to their lives? We don't know. As of today it's just too soon to tell.

I do agree that the potential of treating cancer using the immune system is exciting. Certainly. But right now we're nowhere near able to declare victory or start worrying about the implications of ending cancer. That's not fair to the unlucky majority of cancer patients.

mdekkers 91 days ago [-]
But it offers them additional months of life

Personally, I always wonder why people go through the pain and expenses to add a few more months. Years/cure - yes, go for it. A few months? I'll take the painkillers and anti anxiety drugs, thanks - it was a good run.

shadowtree 91 days ago [-]
absolutely, but also a chicken and egg problem.

a lot of immuno-onco is currently only approved for late-stage cancer patients. basically once you're near death and chemo/radio is done, you get the new stuff. and even within those groups you get people that are cancer-free within weeks. astonishing.

long term survival is unknown - sure. no one has been treated ten years ago with this stuff. besides a time machine there is no way of knowing, just waiting.

watching companies like https://www.modernatx.com/ building whole platforms is super exciting though. as someone who has lost family and young colleagues to cancer, this shit cannot come soon enough.

byteCoder 91 days ago [-]
From an economic perspective, cures (or, even, long-term durable remissions) are definitely disruptive to the current models of care.
iooi 91 days ago [-]
> After a median follow-up of 10.5 months, the estimated rate of overall survival at 12 months was 69.2% in the pembrolizumab-combination group versus 49.4% in the placebo-combination group.

Seriously groundbreaking. This is a once-in-a-decade paper. [1]

[1] http://www.nejm.org/doi/full/10.1056/NEJMoa1801005?query=fea...

mft_ 91 days ago [-]
There have been lots of similar 'groundbreaking' data from the various anti-PD1/-PDL1s over the pest few years. This is great, but not greater than lots of others.
hprotagonist 91 days ago [-]
complaints about study funding aside, checkpoint inhibitors really are stunningly effective for some cancers.

it’s the first major advance we’ve had in oncology in maybe 25 years.

DubiousPusher 91 days ago [-]
Haven't there been fairly significant advances in using specialized chemotherapies for specific forms of cancer? This at least has been my impression from a few books I've read.
patall 91 days ago [-]
More or less correct, the parent comment is nonsense. There are multiple special types of cancer that can be specifically targeted now (for example CML), though few of those are chemotherapies aside some improved targeting mechanisms via antibodies. Also, prognosis accuracy has and is improving dramatically. And there are HPV vaccinations now, targetted virus treatments comming up and so much more. Immunotherapies are great but not the first and only thing in 25 years.
killjoywashere 91 days ago [-]
AACR meeting in Chicago is the real event. If you're a science junkie, http://webcast.aacr.org/s/2018annual/PL01
killjoywashere 91 days ago [-]
Also from AACR: Google Augmented Reality Microscope: https://www.youtube.com/watch?v=9Mz84cwVmS0
schappim 91 days ago [-]
My Father is currently on a trial in Australia which combines Immune Therapy with traditional chemo treatment. The results can only be described as a miracle. He has gone from being inoperable stage IV melanoma (with the disease first being spotted in his lung, not his skin) to showing next to no evidence of the disease.

When I read many medical studies in the media, they often sound too good to be true. In this instance it is the real deal.

I hope access to this treatment becomes readily available for the rest of the public.

lopmotr 91 days ago [-]
Not to be dismissive, but those other media stories often had someone incredibly improve their condition too and that someone would have had children to go around saying "this is the real deal" but it's still only an anecdote and it still only works on some patients. Even quack therapies have people recovering naturally sometimes. Not so say immunotherapy is quackery.
aaavl2821 91 days ago [-]
This is a really significant public health advance.

In the US, cancer is the second leading cause of death, and lung cancer is one of the largest causes of cancer death. Curing this disease, even in a subset of patients, is really amazing

https://www.cdc.gov/nchs/fastats/leading-causes-of-death.htm

https://jamanetwork.com/journals/jama/fullarticle/2678018

zpatel 91 days ago [-]
Thanks for sharing. I wish that instead of building destructive weapons, there was more focus was on building cures for the many diseases and fighting hunger and poverty..
kuwze 91 days ago [-]
I remember reading this recent Financial Times article[0] about how China is innovating in the area of providing immunotherapy and other breakthrough treatments.

[0]: https://outline.com/tdDNdd

[1 non-outlined link]: https://www.ft.com/content/30b5a944-3b57-11e8-b9f9-de94fa33a...

aaavl2821 91 days ago [-]
Right now China is playing fast-follower in general with this work, but rapidly becoming more innovative.

There are quite a few Chinese companies developing their own PD 1, PD L1 and CTLA4 inhibitors (these are the first gen immunotherapy treatments), and a lot of innovation in CAR-T cell therapy (first approved products of this type were US and European, Novartis and KITE pharma). There is less regulation of cell therapy in China, so potential for some breakthroughs.

A company called Legend Biotech in China surprised the biopharma world at a major confreence last year with breakthrough work with a cell therapy targeting BCMA.

However, the amount of US and EU investmnet in immuno-oncology is still greater than in China

hanspragt 91 days ago [-]
Someone close passed away from lung cancer last year. He received immune therapy (keytruda), and while it may work wonders for others, it comes with drawbacks; My main issue was that it takes 4 to 5 treatments (with weeks between each treatment) before you even really know if it worked or not. This is valuable time that could be used to treat the cancer with chemo (which admittedly has way worse side effects than keytruda, but still).
wellboy 91 days ago [-]
Are there numbers that say what the success rate of immuni therapy is?
hanspragt 91 days ago [-]
It sort of depends on what you define as success. The goal was never to "cure" the cancer, rather, to shrink the tumor.

I hesitate to assign an exact percentage to the effectiveness since there are so many factors to consider, but I remember Keytruda being reported to shrink tumors in less than a third of patients who took it.

iooi 91 days ago [-]
The goal is to cure, from the article, quoting the head of lung at Yale:

> “Chemotherapy has limitations. Immunotherapy has the ability to cure. I lead the Yale lung team. We have patients on these immunotherapies alive more than eight years.”

hanspragt 91 days ago [-]
I am sorry, that wasn't clear; That was the goal in the specific case of my family-member. The tumors would never fully disappear, and he would likely need more treatments later on.
agumonkey 91 days ago [-]
Went to a talk about immunotherapy last year, toxicity of these class of therapeutics was way better than the best other available treatment. Sadly still too nascent, but don't forget to ask for it if you can.
suyash 91 days ago [-]
Bad reporting - fails to explain what Immunotherapy actually is, jargons all over. Can anyone explain in simple terms?
leodeid 91 days ago [-]
Check out the cancer.gov page[1], which does a decent job of giving an overview. The drug in question, pembrolizumab, is a monoclonal antibody (you can tell because the name ends with '-mab'), and you can read more about how those work on this page[2].

[1] https://www.cancer.org/treatment/treatments-and-side-effects...

[2] https://www.cancer.org/treatment/treatments-and-side-effects...

waynecochran 91 days ago [-]
Immunotherapy is not new. My mom went to Greece in 1980’s and received it. It was illegal in the US then. She would go to Mexico for booster shots. I believe it really extended her life w quality. She passed in 1990 but looked good... not a bag of bones like chemo patients.
keepper 91 days ago [-]
Odd they don't mention the cuban work on this field.

"Researchers with Cuba’s Center for Molecular Immunology have developed and approved an immunologic cancer therapy that improves survivability for certain types of cancers in some cases; as of January 2017, the drug has begun clinical trials for the treatment in the United States."

https://www.usatoday.com/story/news/world/2018/01/09/cuba-ha...

randcraw 91 days ago [-]
Vaxira / Racotumomab

https://www.ncbi.nlm.nih.gov/pubmed/25420897

https://www.frontiersin.org/articles/10.3389/fonc.2012.00150...

This drug has completed a limited Phase II study in 2014 (71 patients), adding about 5 months of life over the control group (11 mo vs 6 mo). Then it began a large international phase III NSCLC (lung) study which apparently hasn't ended yet.

It's approved for use in Cuba and Argentina, probably only for lung cancer.

keepper 89 days ago [-]
Thanks! Weird I got down voted for my comment..
Clubber 91 days ago [-]
>They cost more than $100,000 a year, can have serious side effects and help only some patients, generally fewer than half.

Fuck you and the fuck the US healthcare system. Daddy or mama gets to live a few more years, but it will put the family into lifelong debt. I'll say it again, fuck you.

aaavl2821 91 days ago [-]
It will be cheaper in the future. Right now there are only ~4 PD-1 or PD-L1 inhibitors on the market, so it is an oligopoly. In a few years there will be a wave of competing drugs (many developed in China) and prices will fall

Also, these drugs don't just extend life a few years for a few patients. Over 50% of patients are responding to these drugs, and some of these can live 10 full years. Is $10,000 / year too much to spend so a loved one can live a healthy life? $50K / year is generally the threshold used by health economists to determine the value of a quality adjusted life year, and in this case these treatments fall below that threshold

And if you have insurance, it will cover much of that cost

danieltillett 91 days ago [-]
...and your solution is what?
Clubber 91 days ago [-]
Government needs to subsidize research and put price caps on resulting drugs. Fair market isn't possible with inelastic demand. That's where the fuck you comes from.

Someone has cancer and their kids are wanting the treatment (of course, it's false hope, we don't want daddy to die) without realizing what they are asking for (lifelong debt). So in addition to cancer, the patient has to grapple with that shit. Anyone with a little financial sense would probably take death, but now they have to explain that to their families why they are denying the treatment (daddy doesn't want to be with us / daddy wants to die?).

Disgusting what this country has become.

danieltillett 91 days ago [-]
Well governments do subsidise research quite a lot (NIH et al).

Putting caps on prices without doing something about research costs is just going to kill research. All the big pharma companies are laying off scientist every week because even with uncapped prices the returns are so low that it is not worth spending the money to develop new drugs.

A more productive approach might be to look into why drug development has become so expensive. It is certainly not because pharma companies have suddenly become greedier.

mft_ 91 days ago [-]
> Putting caps on prices without doing something about research costs is just going to kill research. All the big pharma companies are laying off scientist every week because even with uncapped prices the returns are so low that it is not worth spending the money to develop new drugs.

European countries pay much lower prices (although still relatively high vs. an average salary) vs. the US. The dirty secret is that the US is generally milked by pharma, because it can be. Until the US gets its act together and fixes this --and how likely is that, with the essentially broken system of government?-- it will continue.

> A more productive approach might be to look into why drug development has become so expensive. It is certainly not because pharma companies have suddenly become greedier.

It's expensive because a) it's a long and hard slog, and b) the regulators set very high standards. You can't affect a), and there is a strong disincentive for regulators to change b): in essence, regulators exist to prevent bad things happening, so are only incentivised to ever-tighten regulations.

adventured 91 days ago [-]
> European countries pay much lower prices

To be fair, European big pharma also lives off the US market to plump their margins. That subsidizes their ability to charge lower prices in Europe and elsewhere. They also constantly poach cutting edge biotech & pharma companies out of the US to keep their stables full, such as AveXis, Genzyme, Genentech, etc. Without constantly buying up elite US biotech, Europe would have practically no biotech industry at all.

The US is by far the world's largest drug market. It's heaven for Sanofi, GlaxoSmithKline, Novartis, Roche, AstraZeneca, et al. The US drug market is twice the size of the EU drug market, with ~37% fewer people.

mft_ 91 days ago [-]
> To be fair, European big pharma also lives off the US market to plump their margins.

...as I said in my very next sentence? :)

> They also constantly poach cutting edge biotech & pharma companies out of the US to keep their stables full, such as AveXis, Genzyme, Genentech, etc. Without constantly buying up elite US biotech, Europe would have practically no biotech industry at all.

Can I ask, what's the problem with this?

All of the companies you refer to are pretty-much global - they have a presence in many countries, including the US, and by being publicly traded, ownership isn't especially linked to their country of origin. AZ (for example) being based in the UK means little for the UK, apart from that being where it pays some tax, and employs some people in its head office.

To take one of your examples, Roche (Swiss) bought Genentech (US), and still maintains the same huge presence in SF, still employs people in SF, still pays taxes there. And presumably the previous owners of Genentech stock did nicely out of this?

danieltillett 91 days ago [-]
It is only a long hard slog because of the regulators.

You are 100% right that the problem all comes back to regulation. What is missing from the drug development area is any cost benefit analysis. Regulations are made as if there is no cost to the ever tightening and restrictive regulations.

Clubber 91 days ago [-]
>All the big pharma companies are laying off scientist every week because even with uncapped prices the returns are so low that it is not worth spending the money to develop new drugs.

You paint such a sad, desperate picture, but based on their numbers, it sounds like they are doing it to save a buck. Look at those profit margins. 10-43 percent on billions of investment. I should be so lucky.

http://www.bbc.com/news/business-28212223

Did you know the US government isn't allowed to negotiate drug prices for medicare and medicaid? They (we) just pay whatever the companies want to charge.

danieltillett 91 days ago [-]
Yes they are making lots of money by killing their research pipeline and laying off their scientists. The reason they are doing this is they can't justify spending the money given the returns on offer.

I am no defender of pharma companies, but they are doing exactly what the economic incentives encourage them to do. We need to change the incentives, not just rant about high prices and greed.

Edit. Yes I know that the US government is not allowed to negotiate with drug companies over pricing (it is a little more complex than this in practice), but even with pricing uncapped the profit margins don't justify them spending more on R&D.

We agree on the problem, just disagree on the solution. You should also read the part two of the article you quoted [0]. Unfortunately all the solutions provided are little more than a sugar pill for the real problem - R&D costs.

0. http://www.bbc.com/news/business-29659537

maxerickson 91 days ago [-]
Medicare drug prices are negotiated by the private companies that administer most of the drug coverage.

There is a clause in the law establishing Part D that says the government can't interfere with those negotiations, but this is different than the prices not being negotiated at all.

http://www.pewtrusts.org/en/research-and-analysis/fact-sheet...

Medicaid prices aren't negotiated, but the government dictates that they get near the lowest prices the manufacturer sells the drug for.

refurb 91 days ago [-]
This is all correct, and, research has found that sometimes the Part D plans actually negotiate a lower price for their Medicare patients than commercial.

Also, Medicaid does not only get the lowest price ("best price"), they also get another 23% knocked off.

So to be entirely accurate, the US gov't doesn't negotiate drug prices for Medicaid, it creates it's own discounts and tell the company to screw off if they won't accept them.

wiz21c 91 days ago [-]
I don't know shit, but I think it's not your country only... I've already wrote it but 15 years ago at Johnson&Johnson, I remember that on every desk, there was the motto of the company : "we work for the good of our patients and shareholders" (maybe not the exact wording, I think I recall the idea quite vividly). (noticed it was an "and" not a "then")
neolefty 91 days ago [-]
Could it become cheaper in the future?
Clubber 91 days ago [-]
Highly doubtful in this country.
delbel 91 days ago [-]
Cuba has a lung cancer vaccine for $2. Peer reviewed. You don't hear about it. Edit: I don't even know why I go here if this site is so toxic I get downvoted for pointing out something. Enjoy your guys toxic conformation bias
leodeid 91 days ago [-]
The "vaccine" you refer to here is racotumomab. It's not a vaccine in the common-parlance sense ("prevents disease"), but a different immunotherapy treatment which is only approved for use in Cuba and Argentina. I'm mildly curious why it doesn't exist in the US. All of the clinical trials in the USA which I can find on that drug are either incomplete[1] or completed-but-without-results[2][3][4]. For all of those trials, "Laboratorio Elea" is the sponsor or a collaborator, so I presume they have the rights to the drug in the USA. That's apparently a company out of Argentina[5]. I don't know why they seem to have given up on getting the drug approved in USA, but wikipedia says "[a study] is underway in Argentina, Brazil, Cuba, Indonesia, Philippines, Singapore, Thailand and Uruguay", though the citation for that seems incredibly suspect[6].

[1] https://clinicaltrials.gov/ct2/show/NCT02998983

[2] https://clinicaltrials.gov/ct2/show/NCT01460472

[3] https://clinicaltrials.gov/ct2/show/NCT01598454

[4] https://clinicaltrials.gov/ct2/show/NCT01240447

[5] http://www.elea.com/

[6] https://en.wikipedia.org/wiki/Racotumomab#Clinical_trials

stochastic_monk 91 days ago [-]
The prohibitively expensive nature of any immunotherapy leaves me profoundly skeptical of its practical usefulness. $100,000/year? That's more than twice the median income in this country.

Is it simply that expensive to get mabs from animals, is drug development disgustingly expensive, or is there unbounded greed in pharmaceutical companies?

adrianm 91 days ago [-]
It's way more than $100,000 a year too. My treatment alone (Keytruda, every 3 weeks) is around $300,000 a year; about double the price the company will quote you if you ask, because they don't estimate the cost it takes to get blood work, get seen by an oncologist, and then get the treatment administrated to you safely by a trained nurse ready to respond to any adverse events that may spontaneously occur during infusion. However, thanks to current health care law in the US there are caps on the amount of out-of-pocket expenses your insurance can charge you. I have run of the mill bigco health insurance and my personal max out-of-pocket cost (after premiums, deductibles, etc.) is at least two orders of magnitude less than the cost to insurance.
vibrio 91 days ago [-]
More then last 2 than the first one. Getting money from investors is much harder than getting MAbs from animals. Probably more gruesome, too. Also greed is not just the Pharma. Some Hospitals/physicians use Clinical Trials as a profit center, and see Pharma as a bottomless pit of cash-- its a bit of a vicious circle.
abarringer 91 days ago [-]
I've been in and out of the hospital a bit lately (broken back). That seems downright cheap. I average about $4,000 an hour when I'm in. The most recent "study" took an hour with one low paid tech using one ultrasound machine and it cost over $2,000. CT Scan? 15 minutes $7K. Heck, they charged nearly $800 to "start an IV" when they didn't even start it, it was the ambulance EMT that put it in (billed separately) they just injected morphine into it. If you don't have good insurance you are one small slip away from bankruptcy.
mrnobody_67 91 days ago [-]
Have you tried shopping around?

https://www.healthcarebluebook.com and a bunch of others are trying to provide price transparency. Sometimes 30 min drive means thousands in savings.

murukesh_s 91 days ago [-]
CT scan is less than 100$ in most places in India. It could go up to 200$ in some hospitals and is considered expensive by the patients.
murukesh_s 91 days ago [-]
And ultrasound is 10-20$. I find it seriously expensive in US. One thing is the health insurance or public backed healthcare is not widely adopted and patients still pay from their own pockets in India so charging exorbitant amounts is a big no-no.
joe5150 91 days ago [-]
nothing is “prohibitively expensive” in healthcare unless you can’t afford your out of pocket costs, which is perhaps increasingly the case for a lot of people, but even conventional cancer treatment is still way over out of pocket costs, so I don’t see how the cost of this treatment really makes much of a difference.

if you don’t have health insurance, your floor for “prohibitively expensive” is probably way lower than this already.

firstplacelast 91 days ago [-]
It's all 3.
aantix 91 days ago [-]
PhDs that have dedicated their lives to specializing in specific cancers, failed drugs, research that leads nowhere, failed clinical trials because of XYZ. It's all highly specialized. And if done with a rigorous protocol, it's all expensive.

You're not doing a lifetime of cancer research in hopes that you earn an average salary.

For the company, if you finally get somewhere with a drug that is affective, you have to try and recoup your investment. How else do you fund future research?

Retric 91 days ago [-]
Most US medical research is highly dependent of public funding. Company's are only interested once the risks drop enough and the rewards are very near.

Looking at just research and eliminating patent dogging efforts, Drug companies don't pay for nearly as much research as you might think.

vibrio 91 days ago [-]
I agree that pubic funding is an essential foundation for this industry, but disagree that the risk drops before industry gets a hold of technology. Large clinical studies are crazy expensive for many good and many bad reasons, and many of them will fail giving zero ROI. I agree that much of Pharma, (especially, but not only, some very bad actors) spend more on IP Attys and Commercial efforts than R&D, and that hurts me to watch. Academia doesn't do the research that is required to get drugs to people--who does PK and ADME studies on hundreds of animals? No one excpet industry does the detailed manufacturing process development and critical parameter work required to support approvals, especially in biologics. Yes, many drug companies need to be fixed (and some outright eliminated), but the industry does serve a purpose.
aantix 91 days ago [-]
>One study assessed both capitalized and out-of-pocket costs as about US$1.8 billion and $870 million, respectively.

https://en.wikipedia.org/wiki/Cost_of_drug_development

These numbers certainly aren't risk-free. Even if the company has 10 billion in cash, how many potential research leads can they bring to market? Not many.

refurb 91 days ago [-]
Company's are only interested once the risks drop enough and the rewards are very near.

Clearly not true. Less than 5% of molecules that drug companies pick up make it to market. Huge failure rate.

Retric 91 days ago [-]
1:20 is relatively good odds. A random molecule is something like 0.000000001%.
throwawayf98 91 days ago [-]
> How else do you fund future research?

Taxes?

mft_ 91 days ago [-]
That's kind-of what happens... only in the US, it's a huge tax on ill people, rather than a smaller tax on healthy people.
adventured 91 days ago [-]
You have it exactly backwards. The healthy people are in fact paying for the ill people (who typically don't come even remotely close to ever paying for the cost of their treatment/care). The real cost to cover healthy people is extremely low, they pay artificially inflated prices for their insurance that subsidizes care & coverage for other sick people.

In the US, 5% of patients represent over 50% of the cost of healthcare. 1% of patients are 20% of all expenses. The healthiest 50% represent just 3% of the healthcare system's costs - they're the financial offset group.

For downvoters that find facts uncomfortable: that's why the ACA needed to force all people to have insurance, it's a financial necessity to get as many paying healthy people in the system as possible to financially offset the cost of sick people if you want to try to make it work. This is healthcare system 101.

mft_ 91 days ago [-]
> You have it exactly backwards. The healthy people are in fact paying for the ill people (who typically don't come even remotely close to ever paying for the cost of their treatment/care). The real cost to cover healthy people is extremely low, they pay artificially inflated prices for their insurance that subsidizes care & coverage for other sick people.

Agree - that's indeed how insurance works. :)

I was referring to high co-pays on vastly expensive new drugs, and was also being slightly facetious.