Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

Why new cancer treatments cannot save us

Yongjia Wang
Meds
January 16, 2024
Share
Tweet
Share

In 2020, the ICPerMed (International Consortium for Personalized Medicine) published a ten-year vision for how personalized medicine, a new form of medicine, has the potential to rebuild an equitable and accessible health care system by 2030.

Precision or personalized medicines are drugs developed with genomic sequencing technologies, targeting the critical genes in specific types of cancer or genetic diseases. Thus, PMs are highly effective in treating their targeted patients, sometimes buying patients years compared to other standard treatments.

Since the Human Genome Project’s (HGP) release of the human genome sequence in 2003 and President Obama’s 216 million dollar PM initiative in 2016, more and more scientists and pharmaceutical companies are focusing on this new field.

As a pre-med student who aspires to go into the field of oncology, scientific breakthroughs that led to new medications are beyond exciting. Precision medicines seemed like the first step on a plausible path toward alleviating cancer globally. If we can stratify patients to find the most suitable treatment for all of them, wouldn’t it be a much more efficient way of dealing with global health?

However, I only needed to walk into my first medical anthropology class to know I was wrong. Drugs and medicines are not the only determinants — many more factors contribute to global health. Developing better technology and stronger medicines does not necessarily mean we are improving global health and eliminating medical disparities. We have invested hundreds of millions of dollars, hoping that precision medicine would be the new tool to improve patient care for all. Sadly, precision medicine is not for everyone. It will only widen existing health care disparities and leave people behind.

To start with, the genomic database for precision medicine research is highly unequal between races, with almost 80 percent being European and only 2 percent African. This gap is not due to discrimination but because only developed countries (mainly European countries) can afford to invest in this costly field.

Since different races have different expressions of disease, a lack of research on genetic profiles can cause uncertainty about precision medicine’s effectiveness and side effects. There are fewer diagnosis tests to determine whether black patients match for targeting genomic treatment, and even when they gain access to it, the screenings have lower accuracy. This underrepresentation in research leads to a widening of health disparities between different races.

Omitting the uncertainty caused by racial genetic profiles, the effectiveness of precision medicine still differentiates among patients.

Bevacizumab (Avastin), a powerful PM for cancer, can buy up to two extra quality-adjusted life years (QALY) for the 7 percent of breast cancer patients that have a specific target gene.

Proportional to its effectiveness is its price tag: 100,000 dollars for a one-year supply. Bevacizumab is not the most expensive precision medicine: one single treatment of precision medicine can cost up to 70,000 to 130,000 dollars. Even though genomic diagnostic tests can determine the most suitable treatment for each patient, the cost alone determines that precision medicine is not accessible or affordable for everyone.

For a two-year gain of QALY, this sky-high price might be acceptable. However, regular breast cancer patients without this target gene only gain an extra five months. Human life is priceless, but a 15-month Bevacizumab treatment, which amounts to 125,000 dollars, is much less cost-efficient for the general patient when compared to the targeted group.

To further complicate the issue, only public insurance covers the cost of precision medicines. Private health insurance, not regulated by the government, does not have to cover these treatments. In the United States, where there is no national health care coverage, over half of the people are privately insured. At least in the United States, the uninsured and privately insured population will be ‘left behind.’

Among the publicly insured patients, how should the government decide who deserves this treatment? With the limited funding for medical insurance, the government cannot afford to give this pricey drug to all patients.

ADVERTISEMENT

Do we deny some patients treatment just because it is less cost-efficient? If so, precision medicine and health care seem like an expensive roll of dice to determine your fate.

“Health” should not be like this.

Not every health improvement is due to medical breakthroughs: medical care only accounts for 10 to 20 percent of all health determinants in a population. Socio-economic determinants and environmental factors affect populational and global health on a much greater scale.

In 2016 alone, the U.S. government invested 216 million dollars into precision medicines. Imagine if that money, or even parts of it, went into funding for public infrastructures, creating better working and living conditions, or addressing food insecurities. It would have been more cost-efficient, effective, and beneficial to everyone.

Precision medicine is still an exciting breakthrough. For a high price tag, however, it benefitted a marginal group of people while leaving behind the rest.

It is powerful, but it cannot save us all.

Yongjia Wang is an undergraduate student.

Prev

Why physicians should care about the False Claims Act [PODCAST]

January 15, 2024 Kevin 0
…
Next

Medical aid in dying: time for evidence-based legislation

January 16, 2024 Kevin 7
…

Tagged as: Oncology/Hematology

Post navigation

< Previous Post
Why physicians should care about the False Claims Act [PODCAST]
Next Post >
Medical aid in dying: time for evidence-based legislation

ADVERTISEMENT

Related Posts

  • Using the Avengers to explain how cancer treatments work

    Jennifer Lycette, MD
  • The hidden benefits of your health insurance plan can save your life

    Michael L. Millenson
  • “System-ness”: the key to successful health care transformation

    Robert Pearl, MD
  • AI’s role in streamlining colorectal cancer screening [PODCAST]

    The Podcast by KevinMD
  • Timely treatment decisions: the promise of surrogate markers

    Layla Parast, PhD
  • Hormone replacement therapy is still linked to cancer

    Martha Rosenberg

More in Meds

  • FDA delays could end vital treatment for rare disease patients

    GJ van Londen, MD
  • Pharmacists are key to expanding Medicaid access to digital therapeutics

    Amanda Matter
  • How medicine repurposing enables value-based pain management and insomnia therapy

    Olumuyiwa Bamgbade, MD
  • Forced voicemail and diagnosis codes are endangering patient access to medications

    Arthur Lazarus, MD, MBA
  • From stigma to science: Rethinking the U.S. drug scheduling system

    Artin Asadipooya
  • How drugmakers manipulate your health from diagnosis to prescription

    Martha Rosenberg
  • Most Popular

  • Past Week

    • Who gets to be well in America: Immigrant health is on the line

      Joshua Vasquez, MD | Policy
    • Why specialist pain clinics and addiction treatment services require strong primary care

      Olumuyiwa Bamgbade, MD | Conditions
    • Harassment and overreach are driving physicians to quit

      Olumuyiwa Bamgbade, MD | Physician
    • Why peer support can save lives in high-pressure medical careers

      Maire Daugharty, MD | Conditions
    • When a medical office sublease turns into a legal nightmare

      Ralph Messo, DO | Physician
    • Addressing menstrual health inequities in adolescents

      Callia Georgoulis | Conditions
  • Past 6 Months

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • Who gets to be well in America: Immigrant health is on the line

      Joshua Vasquez, MD | Policy
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
  • Recent Posts

    • The shocking risk every smart student faces when applying to medical school

      Curtis G. Graham, MD | Physician
    • Clinical ghosts and why they haunt our exam rooms

      Kara Wada, MD | Conditions
    • High blood pressure’s hidden impact on kidney health in older adults

      Edmond Kubi Appiah, MPH | Conditions
    • Deep transcranial magnetic stimulation for depression [PODCAST]

      The Podcast by KevinMD | Podcast
    • How declining MMR vaccination rates put future generations at risk

      Ambika Sharma, Onyi Oligbo, and Katrina Green, MD | Conditions
    • The physician who turned burnout into a mission for change

      Jessie Mahoney, MD | Physician

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

Leave a Comment

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

  • Most Popular

  • Past Week

    • Who gets to be well in America: Immigrant health is on the line

      Joshua Vasquez, MD | Policy
    • Why specialist pain clinics and addiction treatment services require strong primary care

      Olumuyiwa Bamgbade, MD | Conditions
    • Harassment and overreach are driving physicians to quit

      Olumuyiwa Bamgbade, MD | Physician
    • Why peer support can save lives in high-pressure medical careers

      Maire Daugharty, MD | Conditions
    • When a medical office sublease turns into a legal nightmare

      Ralph Messo, DO | Physician
    • Addressing menstrual health inequities in adolescents

      Callia Georgoulis | Conditions
  • Past 6 Months

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • Who gets to be well in America: Immigrant health is on the line

      Joshua Vasquez, MD | Policy
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
  • Recent Posts

    • The shocking risk every smart student faces when applying to medical school

      Curtis G. Graham, MD | Physician
    • Clinical ghosts and why they haunt our exam rooms

      Kara Wada, MD | Conditions
    • High blood pressure’s hidden impact on kidney health in older adults

      Edmond Kubi Appiah, MPH | Conditions
    • Deep transcranial magnetic stimulation for depression [PODCAST]

      The Podcast by KevinMD | Podcast
    • How declining MMR vaccination rates put future generations at risk

      Ambika Sharma, Onyi Oligbo, and Katrina Green, MD | Conditions
    • The physician who turned burnout into a mission for change

      Jessie Mahoney, MD | Physician

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Leave a Comment

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...