A recent report from the American Cancer Society found that the death rates for all cancers decreased 1.3% per year from 2001-2006. This is of course after a 21% decrease between 1990-2006. The five year survivial rate for all cancers has increased from 45% in 1975 to 68% currently. One cancer that has seen a large increase in survivial rate has been prostate cancer. The survival rate in the 1970’s was 67%. Today the five year survivial rate is 99.9%. Some cancers have made very little progress in finding any treatment. For instance, there is very little that can be done for pancreatic cancer. The one year survivial rate is only 25% while the five year surivival rate is a miserable 6%.
After looking at this data one might thing well things are getting better. However, one could make the argument that things could be greatly improved. The greatest enemy in the war against cancer is the FDA. It currently takes hundreds of millions of dollars and nearly a decade of research to bring any drug to market. In the meantime while drug companies are trying to get their drugs approved hundreds of thousands if not millions of people suffer as a result. Once a drug is approved however the FDA can’t tell doctors or patients how to use those drugs. This leads to what is known as off-label usage. Off-label usage occurs when a drug is approved for a certain ailment, however doctors experiment and prescribe the drug for a different ailment. A study from Mark Ratner and Trisha Gura in 2008 showed that 50%-70% total usage of cancer drugs are off-label use. It would make sense cancer drugs would have probably the most off-label use since these people have the most to lose. The number of patients just to run trials for the drugs has increased. In the late 1970’s only 1,600 patients were needed. By the 1990’s this number increased to 4,200. This has substantially increased the cost of trying to bring the drug to market which decreases the number of people that can benefit from the drug. People often complain about greedy drug companies. This if of course looking at the effect without looking at the cause. The reason why drug companies charge high prices is because their costs are high due to regulation. The business of creating drugs is based on failures. Drug companies know they will have many of failures which is reflected in the price of blockbuster drugs. The reason drug companies have failures is because the FDA overzealously is obessed with the safety of a drug. The FDA needs to understand that there is no thing as a perfectly safe drug. The question is how to improve the quality and quantity of live in individuals. Of course, there will be trade-offs but let patients and doctors decide. One no brainer solution is once a cancer (or any drug) has passed the first phase of FDA to allow it to be used in the market. The purpose of the first phase is to determine whether or not a drug is safe. Once a drug is determined to be safe by the FDA patients and doctors can run their own experiments to see whether or not it works. Different patients will of course react differently to drugs. By allowing more experiementation there would be more data and knowledge about the drugs which would help drug companies, patients, and doctors. If drug companies were worried about liability they could have patients sign waiver forms or enter into some type of contract that would say if the patient is harm the drug company has to compensate them.
The FDA is creating chronic inflammation in the drug discovery process. Today, patients often have better and more information than doctors of yesteryear. Decentrailizing power and allowing patients and doctors to make their own choices will only improve things. I personally don’t think “cures” exist given one important rule of economics. In life there are no solutions just trade-offs.
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