
Researchers Challenge Low Expectations In Treating Cancer In Poor Countries - JPLeRouzic
https://www.npr.org/sections/goatsandsoda/2019/07/26/745225133/how-to-bring-cancer-care-to-the-worlds-poorest-children
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hprotagonist
Sometimes it's not a myth. We can _cure_ a few kinds of leukemia with T-cell
therapies. There is no way we know of to do so cheaply.

[https://www.newyorker.com/magazine/2019/07/22/the-promise-
an...](https://www.newyorker.com/magazine/2019/07/22/the-promise-and-price-of-
cellular-therapies)

 _Perhaps the most immediate implication of the blurring of lines between
procedure and drug is the conundrum of price. A single dose of Kymriah for
pediatric ALL is priced at $475,000; for Yescarta, a CD19 T-cell therapy
designed for certain types of non-Hodgkin’s lymphoma, that number is $373,000.
These prices rival those of some of the most expensive procedures in American
medicine. (A kidney transplant can be priced at $415,000, a lung transplant at
about $860,000.) And these price tags don’t include the delivery of post-
therapy care to CAR-T patients, who typically suffer complications from the
infusion. Subsequent hospital stays and supportive care can drive the total
costs to a million dollars or more.

...

Drug pricing is, of course, at the center of a familiar and inevitably
acrimonious debate. The pharmaceutical industry defends high prices as a means
to recoup the costs of drug discovery and development. Consumers, insurers,
and governments argue that the prices charged for drugs are out of control,
and bear no relationship to their real costs. But with cellular therapies the
problem isn’t merely profiteering—it is that, unlike conventional drugs, cell
therapies are inherently expensive to produce. The estimated cost to
manufacture a typical CAR-T infusion is close to six figures. In short, even
if CAR-T therapy were offered with no margin of profit, it would still rank
with some of the most expensive procedures in medicine. Extracting cells from
an individual patient, purifying them, genetically modifying them, and
expanding their numbers into the millions will never be akin to churning out
amoxicillin in a factory._

~~~
martinald
There was an excellent BBC documenatry about this subject which may be of
interest: [https://www.bbc.co.uk/iplayer/episode/m0006nzt/war-in-the-
bl...](https://www.bbc.co.uk/iplayer/episode/m0006nzt/war-in-the-blood)

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pkilgore
> _" There's this myth that treating cancer is expensive," ... "And that's
> because the data is almost all from high-income countries..."_

> _Much of the savings, the authors report, comes from the low cost of labor,
> which for the entire cancer center amounted to less than the average annual
> salary for one oncologist in the United States._

It's interesting because I too have been guilty of seeing a price in dollars
and not adjusting for the fact that amount may have vastly different spending
power even within the United States (and thus, less needed for the same
services where there is greater spending power).

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tyingq
_" myth that treating cancer is expensive"_

They use Burkitt's lymphoma as the example. The treatment is intense, but
short duration chemo, and no radiation, or surgery...and less radiology, cat
scans, pet scans, etc. That cuts out a lot of costs.

I'd be interested in what breast cancer, esophageal cancer, etc, cost in the
same region. Those require longer and more rounds of chemo, radiation,
surgery, etc.

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dang
The submitted title was '“There's this myth that treating cancer is
expensive,” says Christian Rusangwa', which broke the site guidelines against
editorializing in titles. Would you mind reviewing them?

[https://news.ycombinator.com/newsguidelines.html](https://news.ycombinator.com/newsguidelines.html)

~~~
JPLeRouzic
I am sorry Dang, I read the rules a long time ago and never thought it was
something forbidden.

In the other hand I do not think the NPR title is very indicative of the
content either: "How To Bring Cancer Care To The World's Poorest Children".
Rwanda is certainly not the poorest country of the world, its large neighbor
RDC, has the third of its GDP per capita in PPP.

Rwanda is one of the most promising African countries. A long time ago it was
labelled the "The Swiss of Africa". What is strange is that 30km to the west
there is the North Kivu, one of the poorest place on Earth.

