UICC World Cancer Congress 2006

Patients want maximum access to potentially life extending or life saving cancer treatments; most also want the access to be based on sound medical evidence. Historically, most cancer advocates have supported research efforts and the innovation that is spawned by free market competition. Today, there is concern that excessive avoidance of risk by decision-makers and the escalating price/access tradeoff present significant threats to progress in drug development and ultimately in access to treatment.

In the short run, serious or life-threatening diseases like cancer will benefit from concerns about safety because the risk-benefit calculus is different from chronic, less threatening diseases. Accordingly investment may flow more freely to therapies for acute diseases like cancer. However, people with life-threatening illness like cancer may be less concerned about safety issues than patients who take drugs for less life-threatening conditions. Excessive concerns about safety and product liability may deter investment in research and have a negative impact across the board if decision makers focus too much on risk avoidance.

As price becomes a more contentious issue, access may be affected by financial considerations in a way that the average cancer patient has not previously confronted. While we do encourage the free market approach to stimulating life-saving research, accelerating prices are increasingly difficult to justify to our constituents as well as to purchasers.

Government, academia and industry must recognize that our efforts have fallen short of what has been promised to taxpayers and to patients. Even the most successful follow-on drugs are limited in their impact on patients, and questions are being raised about the value of certain new products given their high prices yet modest impact on patient survival.

Patient advocates recommend new approaches to public policy related to drug development, taking a long view that is not swayed to one extreme and then another by sensationalist press or political coverage. New partnerships must be forged among government, academia, industry, providers and patients, facilitating more open sharing of information and honest assessment of relative strengths and weaknesses of various ongoing initiatives.