8 Jun 2011

The Business of Hope

As announced in my post "ASCO 2011", the annual oncology conference is presently in full swing.  Interestingly, CNBC has chosen to feature breaking news,  cover junior and senior drug companys' presentations and other items of interest this week on a daily feature they are calling The Business of Hope.  Big business from every possible angle.  As many of you know, corporate finance is my background so this is a subject - sadly, along with the subject matter - that is near and dear to my heart.
Of particular interest this week was the presentation by drug giant Roche/Genentech on their multi-billion dollar product known as Avastin.  This chemotherapy drug is widely used in a number of cancers and is currently in clinical trials for its potential use in ovarian cancer.  So far this week I've seen headlines about the drug which include the words "Roche Scores Again", "Statistically Significant", "Blockbuster Drug", "Boosts Survival"...are you excited yet?  Me too. 
Except... not.  The fine print reveals a 1.5 month increase in progression-free survival using Avastin plus standard chemotherapy versus receiving standard chemotherapy alone in newly treated patients.  The jury is still out on a separate ongoing clinical trial for the drug's use in women who have had previous chemotherapy cycles and are most likely to recur.  So far, the evidence indicates a possible 4 month progression-free advantage.  I've read estimates of the cost per cycle (normally 6 treatments) to be between $58,000 and $88,000. 
I don't know whether to be encouraged or discouraged.  On one hand, millions and millions of dollars are being spent to extend lives but at what real cost?  Not only do I mean hard dollars calculated almost on a per day basis, but nothing has been mentioned about the side-effects associated with, short or long term, living disease-free for that extra month and a half or four months.
We have a friend whose wife died on the ongoing Avastin trial.  The drug, which is a VEGF inhibitor (cuts off the blood supply to tumours) was so effective that it left a hole in her colon.  She is very much one of science's martyrs - a nurse, who knowingly participated for the overall good of others. 
We're all dealing in the business of hope - but we can do without the hystrionics in the headlines.

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