all good with prr, page-24

Your raising a good point here Herro imo:

“However, regardless of how good the Cvac trial results eventually are, patients have to be able to afford the treatment. If PRR doesn’t secure PBS approval in Australia, and the corresponding funding in other countries, the potential usage of Cvac will be very diminished imo.”

The number of people who can afford a course of a new cancer treatment running into say $100k a year is very small.

So in Australia the question is whether the taxpayer picks up the tab. While in the US it is health insurers. In Great Britain it is the National Health Service.

In both the US and Australia many people question the value of these treatments because they represent poor value for the health dollar.

So in Australia as you indicated support groups pressure the government. Just at the time the government is trying to pressure pharma to reduce their price. (You can see some potential for big pharma tricks there can’t you).

Meanwhile PBAC tries to tie funding to real world performance to move the decision out of the political realm.

In the game that counts – in the US its much more complex. The FDA hasn’t considered cost but under the Obarma Healthcare reforms may start. Essentially by upping the ante to a greater emphasis on effectiveness (P4 trials) over efficacy (P3 trials).

So you will have to beat the gold standard (not a placebo) in the real world and at lower or equal cost. And Obarma has tipped a billion dollars into what is termed comparative effectiveness research to develop this rather paradigm changing way of seeing this whole process.

To see the “gap” in what pharma wants and what we can afford – take England. NICE has said $30k maximum per quality adjusted life year for new cancer treatments. Big pharma has said it needs $300k per QALY for new cancer treatments to be viable.

Thats a big difference. The Poms have health care costs per capita half those in the US. Meanwhile the US is running out of money and how long will the rest of the world be happy to fund the lifestyles (and expensive cancer treatments) of the worlds current superpower?

So in a way Herro the question is maybe more about how countries afford these treatments rather than patients.