Shooting for the Moon or Flying Too Near the Sun? Crossing the Value Rubicon in Precision Cancer Care

Abstract

In his last two State of the Union addresses, President Barack Obama has focused on the need to deliver innovative solutions to improve human health, through the Precision Medicine Initiative in 2015 and the recently announced Cancer Moonshot in 2016. Precision cancer care has delivered clear patient benefit, but even for high-impact medicines such as imatinib mesylate (Glivec) in chronic myeloid leukaemia, the excitement at the success of this practice-changing clinical intervention has been somewhat tempered by the escalating price of this ‘poster child' for precision cancer medicine (PCM). Recent studies on the costs of cancer drugs have revealed significant price differentials, which are a major causative factor behind disparities in the access to new generations of immunological and molecularly targeted agents. In this perspective, we will discuss the benefits of PCM to modern cancer control, but also emphasise how increasing costs are rendering the current approaches to integrating the paradigm of PCM unsustainable. Despite the ever increasing pressure on cancer and health care budgets, innovation will and must continue. Value-based frameworks offer one of the most rational approaches for policymakers committed to improving cancer outcomes through a public health approach.

Radiation Therapy Research: A Global Analysis 2001-2015

“…It is thought that further research into these areas could unlock new and more costeffective opportunities for radiation therapy to improve outcomes from cancer. In addition, it would help to ensure that radiation therapy continues to be relevant and that research in this area is prioritized in an era of precision medicine, which is increasingly drug-focused (7,8).…”

Delivering the precision oncology paradigm: reduced R&D costs and greater return on investment through a companion diagnostic informed precision oncology medicines approach

“…Previous analyses have indicated that oncology is the most expensive R&D medicines domain, and companies’ strategies are predicated on driving premium pricing, i.e. what the markets will bear, commercial approaches that threaten to undermine healthcare budgets [ 2 , 27 , 28 ]. Our data for oncology medicines from 56 companies over a 24-year period suggest that in the case of precision oncology medicines, this need not be the case.…”

Landscape of Manufacturing Process of ATMP Cell Therapy Products for Unmet Clinical Needs

“…This product named as Cx601 by Takeda and TiGenix has received orphan status by the Swiss Agency for Therapeutic Products (Swissmedic) for the rare disease. While these innovations are taking place at immense pace, there is growing requirement of policymakers to be engaged along with patients' community to see how best a value-based frameworks and be drawn as rational approaches to use these expensive novel therapeutic modalities in patient care [98].…”