A Survivor’s Take on Cancer Drugs and the “Moonshot”
Here’s why you should support innovation in pharmaceuticals: it’s the path to a cure.
For the first half of my life, cancer was something I never thought about. Then, after being diagnosed with Hodgkin’s Lymphoma at 17, it became the thing that shocked me, that I overcame, that I feared returning, and eventually that shaped my career. I’m not only a cancer survivor; I’m also a health economist and health policy expert focusing on innovative cancer drugs and patient access to medicines.
We need a cancer moonshot.
We can achieve a cancer moonshot by investing in science.
But — we will never achieve a moonshot if the public, politicians, and media continue to bash pharma and biotech companies instead of recognizing that they are the innovation engines driving cancer’s cures.
(Full disclosure: I was previously employed by a pharmaceutical company, pharma and biotech companies are among my consulting clients, and I’m proud of that.)
As someone whose life has been saved and who has now enjoyed yet another cancer-free year due to pharmaceuticals, I am befuddled by the vitriol so many Americans spew at “Big Pharma.” Maybe they just haven’t had the experiences I’ve had, whether that was sitting in a chemo chair hoping the infusions would work to eradicate a tumor, or watching pharma company colleagues stay late at the office to handle phone calls from doctors working to get their patients on a new therapy that was just approved.
Luckily for all of us, cancer drugs have improved drastically in the past 20 years. The regimens many of us survivors endured in the 1990s have been displaced by new technology that gives people the ability to keep working during cancer treatment and frees them from long-term negative effects of treatment. What has brought about these changes? Innovation, and investment in science, from government-supported basic scientific research through to biotech and pharmaceutical companies that translate a scientific premise into a product and take it across the finish line Cancer treatment has become more successful and less brutal. We all have the pharma and biotech industry to thank for much of that.
Some people complain that the prices paid for these drugs are too high, or that pharma companies make profits that are too big. I would ask: what should be the profits on inventing medicines that save thousands of lives? Why shouldn’t health insurance, that as a patient you have paid for, ensure that you receive the best available cancer care no matter what it costs? And why are health insurers trying to put more share of costs onto patients, even while both insurers and hospitals are sharply raising prices and achieving record profits?
I would love to be able to give every reader a crash course in health economics, policy, and pharma pricing to explain why cancer drugs are a great value to patients. Excepting some rare bad actors, pharma execs set prices fairly to reflect the amazingly high, innovative value that drugs bring to patients and the doctors who treat them.
Yes, pharma makes profits, but there are other health system players who profit enormously without contributing what pharma/biotech does to actually saving lives, nor to scientific innovation. Perhaps the Cancer Moonshot can drive a restructuring of American health care where innovation is profitable and administrative paper-pushing is not. Here are some examples of how our system is unbalanced:
1HOSPITALS AND PHARMACIES CAN GET A HUGE DISCOUNT ON DRUGS, BUT STILL CHARGE PATIENTS FULL PRICE.
There’s a government-mandated program called 340B that provides much lower drug prices — discounts of 25% to 40% — to nearly half of US hospital systems and to many pharmacies. Hospitals claim this discount covers care for the uninsured, but even after the Affordable Care Act and the lowest ever number of uninsured people, 340B participation by hospitals and pharmacies continues to grow at enormous rates every year. Some critics have called this program a “hospital and pharmacy enrichment scheme,” mainly because the reimbursement hospitals receive for those drugs is based on the full, “retail” price, meaning that patients do not get to share in the discount. Funding for this discount comes directly from drug manufacturers, lowering their selling price and creating a subsidy to hospitals that lessens pharma and biotech revenues.
2 PHARMA GIVES AWAY LIFE SAVING DRUGS WHEN PATIENTS CAN’T AFFORD THEM. INSURANCE COMPANIES DON’T.
Pharmaceutical companies give away millions of dollars every year in free drugs, copay assistance programs, and donations to independent foundations such as the Patient Access Network and HealthWell Foundation. We’re talking about hundreds of millions of dollars in total. No other industry gives its products away for free to people who can’t afford them. Companies would give away more, except that laws don’t allow direct manufacturer assistance to Medicare and Medicaid patients, even though these patient groups are sometimes the least able to pay for medicines. Health insurance companies do not contribute to these charitable programs, and in many cases, oppose their use, because if a patient is able to afford the copay, it means the insurer has to cover the remaining cost of the drug.
3HEALTH INSURANCE IS A BUSINESS, MORE WORRIED ABOUT ITS SURVIVAL THAN YOURS.
Some of the organizations purporting to be independent evaluators of drug “value” or health care quality are owned by health insurance companies or funded by insurers, creating a huge conflict of interest. These companies are creating information products that insurers use to deny coverage of medicines, justify higher copays, and in some cases force patients to try older drugs with more side effects before they are “allowed” to use a newer, safer, product.
Of course, health insurers would love to see lower drug prices. But if this happens, it won’t lower premiums. Already, insurance companies fail to pass along the rebates and discounts they receive on to their customers, and instead have been raising premium prices and padding their profits. Cancer drugs make up a very modest part of the nation’s health care budget when compared to hospital services, physician visits, and chronic care for diseases such as diabetes, obesity, and COPD. Yet, with this relatively small overall investment, humankind has managed to push back the tide on the most feared and intractable of diseases, to make cancer no longer a death sentence, and to see a rising wave of cancer survivors like myself who are free of disease and now numbering nearly 15 million strong. We need to be doubling down on our research and drug development efforts in cancer across both the public and private sectors, not putting down the innovators that have been leading in this race. The US health care system is far from perfect, but the price of cancer drugs is not the cause of that imperfection.
We can achieve a cancer moonshot. We indeed need it, to spur ahead innovation that has never moved faster, that has taken many types of cancer from “certain death” to “manageable for a time and perhaps curable” and could soon lead us to “curable in most cases.” Is this not the goal? But it won’t be achieved with government investment alone, nor against the backdrop of slamming the pharmaceutical industry and arguing that their products don’t create enormous value for all of us — the survivors, the future patients, and our families and nation.
Let us cheer for cancer drug development with the same groundswell of excitement that propelled scientists to discover a polio vaccine and land on the moon. Let us celebrate the unflagging dedication and innovative spirit of men and women who are fighting the fire-breathing dragon of cancer with their intellect, creativity, and perseverance of scientific discovery. Let us cheer on our pharma and biotech companies as they achieve heights of health and science that no organizations of humans have previously achieved in terms of deploying intelligence to stop death and disease. Let us demonstrate the strength of American science, and let us inspire a new generation to pour their talent into medicine, biology, and chemistry that can cure the next wave of “impossible” illnesses.
I’m a cancer survivor, and I support the community of cancer patients, cancer doctors, cancer researchers, and cancer drug innovators who work daily in search of new treatments and cures. I support science, and I am proud to work alongside the companies that are transforming the trajectory of cancer in America.