At what price?

One last idea to think about from The Scientist. It was a sidebar to an article so I’m going to quote it in full here. It raises some questions about what the cost will be–financial and otherwise–with more targeted and presumably, more effective cancer treatments.

Ask a few scientists what might cloud the future of biomedicine’s asymmetrical struggle with cancer and you’re likely to get different answers that boil down to the same bottom line. “This is not going to be a cheap solution to a problem,” warns the University of Arizona’s Laurence Hurley. He concurs with Genzyme’s Charles Nicolette that the costs will outweigh the benefits in prolonged survival, but he says the difficulty lies in getting governments to invest far ahead of anticipated returns. Karol Sikora of HCA International offers a care-oriented assessment of the money issue: “All you’re doing is keeping elderly people going for a few months longer, when you could be spending those dollars on making other lives significantly better.”

Other monetary considerations that could accompany the achievement of personalized medicine are an elevated threat of lawsuits and more stringent regulatory demands. “It would be very, very difficult to do something not tested because it’s so individualized,” says Oxford University’s Graham Richards. “The metabolite being chewed up by the body and becoming ineffective, or some other metabolites being toxic, are serious problems that always must be borne in mind.”

Victor Velculescu of Johns Hopkins proffers yet another concern related to the consumer culture. “Although there’s a lot of promise in these technologies, we don’t want to oversell them to patients as cures, or make them more than what they are.”

And Hurley adds a similar “buyer beware” twist to his worries about insufficient funding. “The second fear I have is that as we become more and more successful at this type of targeted therapy, people will become more lax in their attitudes toward smoking, diet, and general lifestyle choices.” Pointing to this problem among AIDS patients, he admonishes, “It’s far better to prevent than to treat.”

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