Why Preventing Cancer Is Not the Priority in Drug Development

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Why most of the research focuses on treating cancer rather than preventing it?

This is because the economic resources motivate researchers to focus on treatment rather than prevention. More profits have been made, investing in medication that extends the lives of cancer patients by even a few months rather than investing in medicines that would altogether prevent the development of cancer.

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R&D on cancer prevention and treatment of early-stage cancer is very socially valuable, but developing drugs to treat late-stage disease is usually much faster than developing drugs to treat early-stage disease or prevention. This is because late-stage disease is aggressive and progresses rapidly. This allows companies to see results in clinical trials more quickly, even if those results are only in the form of small improvements in survival.

Drug manufacturers always rush through their product to be safe and effective, so they get patent(s) for the drug and approval from FDA. Their drug can thus be in market for longer time until the patent runs out. This is the period of time during which profit margins are the highest. They call it as “commercialization lag,” the time between the receipt of a patent and FDA approval; this favors the development of drugs with a smaller survival benefit.

Though a patent lasts 20 years (before any extensions), a typical drug comes to market with about 12.5 years of patent life remaining. So if the safety and efficacy of the drug can be demonstrated more quickly in patients, this lag can be reduced.

Heidi Williams, an MIT economics professor studied the problem along with other economic professors of University of Chicago and estimated that the commercialization lag’s incentive to invest in drugs of shorter duration benefit led to 890,000 lost life-years among American patients who were found to have cancer in 2003 alone.

According to their study analysis, some ways to address the commercialization lags are :

1. To shorten the time needed to obtain FDA approval, grants are given based on indications of improved health using surrogate endpoints. The researchers suggested that approval of drugs based on surrogate end points found no difference in the number of clinical trials by survival rate and most cancer drugs in recent years have been approved on the basis of surrogate endpoints.

2. The investigators also found that extending the period of a drug’s market exclusively compensate for the commercialization lag.

Thus, drug patents and FDA approval are a check for drug safety and efficacy. The way they work together affects the incentives for research and could reduce the view on cancer prevention further more!

Source – NY times.