W

hen doctors talk about a new leukemia drug from Novartis, they ooze enthusiasm, using words like “breakthrough,” “revolutionary,” and “a watershed moment.”

But when they think about how much the therapy is likely to cost, their tone turns alarmist.

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  • Maybe the US government spent $200 million for CAR T that directly benefitted KITE Pharmaceuticals, but Dr. Carl June and the team at University of Pennsylvania could not get one dime out of the NIH. Penn’s research was funded privately mostly by the Leukemia and Lymphoma Society and the American Alliance for Cancer Gene Therapy. Also, we can beat up on Novartis for pricing all we want, but they have been dumping tens of millions of dollars into facilities for production (original price for their Morris Plains plant was $42 million) and research ($20 million to UPenn for a new research facility). Also not included are the companies that Novartis bought and teamed with since 2012 to supply vector and other materials. After all that, Novartis has to be way in the hole with this therapy. The current treatment of years of chemotherapy, supportive care, multiple hospitalizations probably far exceeds $625k, not even putting a price tag on the human suffering. How does $625k compare to the cost of stem cell transplant? The human suffering far exceeds any treatment really. Plus, how can you beat blowing away a patient’s leukemia in three weeks? There is a lot of reporting about CRS, but if patients go into CAR therapy with a low disease burden, CRS is negligible. If we flag patients for this therapy early instead of waiting until they are terminal, we can save all the failed treatment costs and suffering. After that analysis, $625k starts to look like a fair price.

  • “A third company, Juno Therapeutics, halted the development of one its CAR-T cell therapies after five patients died from complications of the treatment.”
    I believe only CGTC (combined gene therapy of cancer), which I invented when at NCI, should be used to cure cancer. Michael Lerman, MD, PhD.

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