why don't you let people decide what works and what doesn't.....take the politics out of it...A system which assumes individuals do not act in their own self-interest is not a good system.
Why anyone would expect better decisions to be made by third parties who pay no price for being wrong is one of the mysteries of our time.T Sowell
The most basic question is not what is best, but who shall decide what is best."-Thomas Sowell
Thank you for this article. As a former FDAer preparing to join pharma, I think it's important this this perspective is heard. I hear so many people touting the benefits of MRD and you make a compelling case for caution.
"Since myeloma patients can live 15 years or more— any neurologic damage or parkinsonism or blindness— is a catastrophic risk."
On the other hand, 15% will die within a year of diagnosis and another 45% will die within 5 years. That don't have years for us to worry about possible long term side effects. Are to let them die untreated because there might someday have a side effect turn up?
Yes very similar in NHS but pharma has an influence through career minded achedemics and government officials (jobs waiting for when you leave) and patient groups but I agree with your main point.
Thank you fighting the fight for protecting the patients. Your patients are blessed by your courage, wisdom and knowledge. Thank you for speaking out. The sadness comes when many patients with a new diagnosis will see oncologists that go along with the 3 letter “bought out ruling bureaucrats”.
Healthcare can't bankrupt America. America is already bankrupt and so called healthcare has certainly helped it get to that point. Whenever the connection between buyers and sellers of goods and services is broken, demand and associated costs will soar. This is particularly true when the buyers are fooled into thinking that someone else is paying the bill. Movement toward a solution would require the return to free market principles and an insurance system that operated on conventional actuarial principles.
I read about a case of government meddling in markets that took place in the Ottoman Empire several hundred years ago. One particular Sultan decided that the pottery from Nicaea (modern Iznik) was getting too expensive. This pottery was known for its beautiful intricate glaze patterns/motifs. But he thought something needed to be done about the price so he fixed an upper limit to what the potters could charge. I probably don't have to tell you this caused the collapse of that industry in short order. He may have been the Sultan but the potters had the freedom to tell him to stuff it and to find other occupations to pay the bills.
This is a basic principle of free markets, that artificial price fixing destroys markets, but people keep thinking it will be a cure for high prices.
When I was in practice I soon learned that I should wait 1-2 years after approval of new drugs under the standard approval process. Depending on the drug put forward you would need 30,000 patient years completed to even look for the true adverse event possibilities.
I'm not a medical professional but I've learned through sorrowful experience to avoid new meds. Very interesting what two or three years post-approval can see for a given drug. Lyrica for example, Neurontin's successor. Turns out it can can cause suicidality in patients. How many had to die before the FDA made that a warning?
why don't you let people decide what works and what doesn't.....take the politics out of it...A system which assumes individuals do not act in their own self-interest is not a good system.
Why anyone would expect better decisions to be made by third parties who pay no price for being wrong is one of the mysteries of our time.T Sowell
The most basic question is not what is best, but who shall decide what is best."-Thomas Sowell
Thank you for this article. As a former FDAer preparing to join pharma, I think it's important this this perspective is heard. I hear so many people touting the benefits of MRD and you make a compelling case for caution.
Always appreciate your more thoughtful approach to these issues.
"Since myeloma patients can live 15 years or more— any neurologic damage or parkinsonism or blindness— is a catastrophic risk."
On the other hand, 15% will die within a year of diagnosis and another 45% will die within 5 years. That don't have years for us to worry about possible long term side effects. Are to let them die untreated because there might someday have a side effect turn up?
I think your point is well made about efficacy and approvals. But how about continuing
Yes very similar in NHS but pharma has an influence through career minded achedemics and government officials (jobs waiting for when you leave) and patient groups but I agree with your main point.
Thank you for your continued boldness in speaking out. This all can make one sick at heart.
Too much looting going on in the US health care industry. We in the medical field ignore it at our peril.
Thank you for your integrity and for picking up this (albeit small) megaphone in recent years, Vinay.
“Medicine has become a financial commodity with the rare adverse event of better health outcomes.”
Put another way, quoting the wise Pogo, “We have met the enemy and the enemy is us.”
Thank you fighting the fight for protecting the patients. Your patients are blessed by your courage, wisdom and knowledge. Thank you for speaking out. The sadness comes when many patients with a new diagnosis will see oncologists that go along with the 3 letter “bought out ruling bureaucrats”.
Healthcare can't bankrupt America. America is already bankrupt and so called healthcare has certainly helped it get to that point. Whenever the connection between buyers and sellers of goods and services is broken, demand and associated costs will soar. This is particularly true when the buyers are fooled into thinking that someone else is paying the bill. Movement toward a solution would require the return to free market principles and an insurance system that operated on conventional actuarial principles.
I read about a case of government meddling in markets that took place in the Ottoman Empire several hundred years ago. One particular Sultan decided that the pottery from Nicaea (modern Iznik) was getting too expensive. This pottery was known for its beautiful intricate glaze patterns/motifs. But he thought something needed to be done about the price so he fixed an upper limit to what the potters could charge. I probably don't have to tell you this caused the collapse of that industry in short order. He may have been the Sultan but the potters had the freedom to tell him to stuff it and to find other occupations to pay the bills.
This is a basic principle of free markets, that artificial price fixing destroys markets, but people keep thinking it will be a cure for high prices.
A great example showing that eternal truths truly go back to even the earliest times.
I’m equally concerned that the brainwashing of our youth will expedite that.
When I was in practice I soon learned that I should wait 1-2 years after approval of new drugs under the standard approval process. Depending on the drug put forward you would need 30,000 patient years completed to even look for the true adverse event possibilities.
Respectfully
Gerald M Casey MD
I'm not a medical professional but I've learned through sorrowful experience to avoid new meds. Very interesting what two or three years post-approval can see for a given drug. Lyrica for example, Neurontin's successor. Turns out it can can cause suicidality in patients. How many had to die before the FDA made that a warning?
Multiple myeloma drugs can cost $600,000 per year of treatment
4 years ago I was diagnosed with SMM (smoldering multiple myeloma)
IF it moves from smoldering to full blown, I have no intention of
allowing them to use any 'treatment' (and I have looked at what treatment would
means:
#1 I would not survive given I am panhypopit
#2 At my age, what would be the reason to prolong so the cost
would be a 'no worries'
Bad enough that my drug regiment to treat panhypopit includes
nightly injections of HGH amounting to $100 nightly.