June 24, 2018

HEALTH REFORM IS ABOUT REDUCING CONSUMPTION:

Tweeting Oncologist Draws Ire And Admiration For Calling Out Hype (Richard Harris, 6/24/18, Morning Edition)

 At just 35 years old, Dr. Vinay Prasad has made a name for himself calling out the hype surrounding precision medicine and confronting other examples of hype in his field. [...]

The problem, in his eyes, is that the field has gotten so enthusiastic about these drugs that doctors aren't waiting for actual science to distinguish between the conditions where they are useful and where they are, instead, a very expensive, wasted effort.

"A lot of people want to push it to the treatment side," he says. "They want to get Medicare to pay for it," even before [the drug is] approved for that specific purpose.

Prasad says the drug industry is happy not to shoulder the costs of research when doctors will prescribe their medicine anyway. "And that's the root of what bothers me about this."

Indeed, the high costs of these unproven - and often failed - treatments fall to people who buy health insurance and who pay taxes. It is, in essence, a massive uncontrolled experiment, and nobody's even collecting the data most of the time to find out what might be useful.

Often, doctors run genetic tests on tumors to see if they carry a mutation that will respond to a targeted drug. More than 90 percent of the time, there's no match.

But doctors are increasingly giving these targeted drugs anyway to patients who have the mutation in a type of tumor that has not been shown to respond to the drug. While that sounds rational, it often doesn't work in patients.

One study to explore these non-approved uses is the NCI-MATCH trial. At the ASCO meeting, scientists reported on early results from about 150 patients who were matched to drugs based on their tumor's genetic fingerprint, rather than the type of tumor. The results were disappointing. The tumors responded poorly or not at all to the targeted drugs.

Posted by at June 24, 2018 11:36 AM

  

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