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With contributions from David Brindley.
We recently discussed the role that consortia could play in accelerating the timeline of discovering and implementing new treatments, covering the ‘partnering’ aspect of the ‘Partnering for Cures’ conference held in New York City that was referenced. It, therefore, seems appropriate to devote some time to the ‘other half:’ cures.
A cure is a treatment, or series of treatments, that completely rids a person of a disease or condition, usually with the implication that it will be long lasting. We are coming to an incredibly exciting, yet highly contentious, period in history when cures for serious diseases really can and do exist; the problem is that our current system – from innovation pipeline to reimbursement models – may not be built for it.
The second day of the conference saw an in-depth treatment of the true cost and value of innovation. Recent criticism of the prices for orphan diseases and cancer treatments by prominent U.S. medical associations has stimulated this discussion. The hepatitis C drug Sovaldi, which costs $84,000 for a full course of treatment, exemplifies this. It can effectively cure hepatitis C, but came under fire from U.S. senators when the ‘true’ cost of a full course of treatment was estimated at a considerably lower $36,000.
A large focus of regenerative medicine is developing one-time treatments that have a long lasting impact. ViaCyte, Inc. for example, is developing a stem cell-based product that aims to replace defective β-cells that cause diabetes. If successful, it will remove dependence on regular, painful insulin injections. The difficult question is: how much should we pay for treatments like this?
Treatments that are needed throughout the life of a patient clearly provide sustained and guaranteed rewards to the drug developer (within the patent lifetime, at least). With cures, on the other hand, there is only one opportunity per patient to generate profit. Given the gigantic costs that are incurred during product development, this must be reflected in pricing decisions that are made.
Patient independence is a huge monetary relief for government funded institutions and programs, as well as to society in general. Cures can provide this. Improvements in quality of life and productivity, not just of the patient but also caregivers, and increased in-patient facility space are just some of the many long-term factors that need to be taken into account. The value of a cure is much greater than the cost to produce it. And the value is what should define the price.
In a brilliant TED talk challenging the way we think about charity, activist and fundraiser Dan Pollota said this: “We have a visceral reaction to the idea that anyone would make very much money helping other people. Interesting that we don’t have a visceral reaction to the notion that people would make a lot of money not helping other people.” The same sentiment applies to medicine.
Like it or not, it is a fact that, in order to continue to incentivize innovation of cures, developers of treatments will have to be fairly compensated and, indeed, generate profit. This is, ultimately, in everyone’s interest, both in terms of health and, in the long run, finance. Nowhere is this truer than regenerative medicine.
James Smith
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