To add to the previous post on pharmacogenomics, here’s another aspect of the coming ability to get more and more specific information about cancer characteristics. Not only will there be more "personalization" of cancer treatment based on new depth, but it’s going to yield yet more complications in drug development and pricing.
But as we move into the world where we know more about what we’re
doing…cancer is going to slowly turn into a constellation of hundreds
(thousands?) of orphan diseases, each of which will have its own
particular preferred therapy. We won’t need new drugs for all of them –
many of these will be particular combinations of known agents – but
we’ll need a lot more than we have now. And the market size for each of
them might be at least an order of magnitude smaller than we’d like.
That, naturally enough, will mean that the prices of these drugs
will go up, because they’re probably not going to be any cheaper to
develop. So we’ll have a lot of drugs, each of which can do great
things for a small set of patients, and each of which will cost a heap.
Doctors will have no problems with this, and patients will adapt to
this world without many complaints. We’ll adapt to it in the drug
industry. But think about how this is going to look to an insurance
company or HMO. . .
By the way, this blog, In the Pipeline, by Derek Lowe, is a good one about the biotech industry from a knowledgeable insider.