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Comment by ryeguy_24 | Hacker News Reader

"The ready-made approach could pose a challenge to companies including Juno Therapeutics and Novartis, each of which has spent tens of millions of dollars pioneering treatments that require collecting a patient’s own blood cells, engineering them, and then re-infusing them."

Is author serious with this statement? Two kids lives were saved with a potentially inexpensive technique and the author think's this point is relevant? If 500 companies go bankrupt because cancer is cured, that is a monstrous win.

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> Is author serious with this statement?

Whether or not this author is serious, there are many people who are deadly serious about this sort of thing. It's one of the main reasons that, for example, marijuana has been kept illegal despite the overwhelming evidence that it is less dangerous than either alcohol or cigarettes: legalizing pot is bad for established business interests. It's the reason that credit card transactions cost 2-3% when the technology to process payments for an order of magnitude less has existed for years. It's the reason "low fat" became a thing when sugar is actually much worse. It's reason you can't buy an open-source mobile phone. I could go on and on.

Though none of those things are life and death so not sure relevant.

They certainly are matters of life and death. People die from obesity, diabetes, and cancer caused by sugar and cigarettes. And medical marijuana is a matter of life and death for some ALS and cancer patients who can't tolerate chemotherapy otherwise. For example:

http://www.chicagonow.com/soapbox-momma/2016/10/illinois-man...

Farther back in the history of the demonization of marijuana you'll find it's connected to an argument used by fundamental Christians, Evangelical Christians, related to demons, spirits and the spirit world. Now combine that with fundamental republican right.

Prohibition may have been pushed using a Christian narrative but only because it made it an appealing message for the wider population that wasn't going to just take "look, we can sell way more paper and cigarettes now" as justification.

And that technique continues to be effective. If anything, it has become more viable over the years. I honestly don't understand how anyone can look at the prosperity gospel (https://en.wikipedia.org/wiki/Prosperity_theology) and not see the blatant cynicism behind it.

Don't forget racism - reefer madness was invented to further joint stigmatize minorities and MJ (pun intended).

I don't see it as the author complaining about the danger to the companies but merely stating it. It's not only just OK, but also necessary to throw light on this.

Agreed, but it's still the 3rd of 16 paragraphs. I think it's far the most relevant item.

Think of it as a warning.

I agree, especially considering that the author also mentions relations to expose potential bias or conflict of interest (italics are mine for emphasis):

>Although the cases drew wide media attention in Britain, some researchers said that because the London team also gave the children standard chemotherapy, they failed to show the cell treatment actually cured the kids. “There is a hint of efficacy but no proof,” says Stephan Grupp, director of cancer immunotherapy at the Children’s Hospital of Philadelphia, who collaborates with Novartis.

Yes, the author is serious that investors worry about losing billions of dollars. If your house or savings became worthless overnight, I suspect you'd be worried too.

It's a statement of fact. If UCARTs come to prominence on the market, Kite & Juno no longer appear to be the only game in town (or even the only CAR-T game in town!). Toss in some grade IV/V events in their clinical trials, and an investor in these companies might have reason to worry.

Individuals and societies can have conflicting priorities. Sometimes the same individual may be conflicted (plenty of oncologist friends invest in various companies, and are distressed if a competing company's drug blows their holdings' product out of the water, even as they consider switching patients to the more effective drug). Put differently, you can own a Tesla and hold Exxon stock ... and that does not make you a bad person.

Infant leukemia is (thankfully) rather rare. Nobody who's ever seen a cold, gray infant in a morgue drawer would ever say that those lives are worth less than some company's profits. But they might regret investing in the company!

I read that as a caution that these companies could try to fight this technique, or that it could face problems getting to market, not saying that it was somehow sad that these companies would face trouble.

I hardly think a treatment costing $4000/dose to manufacture is inexpensive.

To cure cancer and live? Seems pretty cheap to me.

I didn't say it wouldn't be worth it, just that it's expensive. There are certainly access issues to consider here if this comes to market.

Some people don't have $4000 so it's not a matter of deciding whether parting with that much money is worthwhile.

And the status of a lot of people's health insurance is suddenly up in the air.

First result on Googling the normal cost of cancer treatments

> Newly approved cancer drugs cost an average of $10,000 per month, with some therapies topping $30,000 per month, according to ASCO, which discussed the costs of cancer care at a recent meeting. Just a decade ago, the average cost per month of new drugs was about $4,500.

It seems $4,000 is rather a small fee in comparison.

Nitpick: it's $4000 per dose, and you're comparing to the monthly cost

> Some people don't have $4000 so it's not a matter of deciding whether parting with that much money is worthwhile.

But then those people wouldn't be able to afford other treatments either.

The insurance market and the government providing medicaid loves these types of cures. An effective cure that costs a few thousand dollars is obviously worth the healthy cured people living to pay premiums for the rest of their healthy life. Much preferable to a costly patient needing many treatments in the tens of thousands of dollars in the insurance pool. The economics are much better than what the system currently bears.

It seems somewhat inline with epipens being 600 dollars..

How much were the first large-screen LCDs? How much are they now?

Technology products often decrease in price. But for cancer treatments it's the opposite. New treatments used to cost $4,500 a decade ago and cost $10,000 to $30,000 now.

Agreed. Patent and insurance reform are crucial.

That's a function of perverse incentives, rather than some sort of immutable truth. If there were stronger penalties for (e.g.) cartel-like pricing (e.g. TKIs), and more price transparency for the true costs of care (ibid), we might see less of this. Or if, say, the primary market for such drugs adopted a single-payer system where the payer negotiated on behalf of the patients, rather than on behalf of its shareholders.

Gleevec and Sprycel are the canonical examples of "competition makes the price go up" but if a single payer dominated the market and used this as leverage, it would be simple enough to just say "not at that price" and force manufacturers to play ball. The real problem is regulatory and legislative capture which prevents this from happening.

Unfortunately the market for therapies does not follow the same market scaling model as consumer electronics due to the various financial models of insurance companies, government subsidies, etc.

If I understand that the article is claiming a new treatment could cure cancer for $4000, then this is orders of magnitude cheaper than all the combined treatments that are administered now to treat cancer.

I agree the manufacturing cost of $4,000 doesn't seem unreasonable, but that's the manufacturing cost. The article also states either of these competing treatments would cost insurers half a million $ or more, so it will be much more expensive than today's treatments. Still worth it, but absurdly expensive especially compared to the manufacturing cost.

If you read a little more carefully, it says the full treatment costs about $50k.

It appears the treatment was a single dose.

" Two infants with relapsed refractory CD19+ B cell acute lymphoblastic leukemia received lymphodepleting chemotherapy and anti-CD52 serotherapy, followed by a single-dose infusion of UCART19 cells"[1]

With that context, it's potentially cheaper than other therapies.

[1]http://stm.sciencemag.org/content/9/374/eaaj2013

doubt it would stay that expensive if proven, mass manufacturing surely would drop it quickly.

with regards to the mention of other companies more complex methods, perhaps its merely reminding people that complex solutions are not always the only way

> Two kids lives were saved with a potentially inexpensive technique

Potentially saved. They did get traditional therapy first. This type of conclusion is really premature. Don't get me wrong, this is super exciting. But the reason we have standardized clinical trials is to ensure treatments work reliably and consistently across as many humans as possible.

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