Their stock price could hit zero for all I care

Cancer is such a complicated disease. There doesn't seem to be one cause and it varies by kind of cancer. I appreciate the frustration that caused the rant, but I think your conclusions are all wrong. First of all, we have made great strides in cancer treatment. My mom died from breast cancer in 1990. A sibling had it in 2001 and is doing well so far. If the treatments available in 2001 had existed in 1988, 1989 and 1990, my mom might have lived. I know enough about the research, the drugs and the studies they are doing that show how to be aggressive in the most effective way with chemotherapy to say that in 1990, she had some odds, but not great odds. Today, her chances for 5 or 10 year survival would have been markedly increased, to where the odds would have been in her favor. That is only a 17 year difference. put it in perspective of how medical innovation used to take hundreds of years to make those kinds of strides.

Secondly, any kind of definitive cure for even the most obscure cancer would be a cash cow for one of the pharmaceutical companies. They just aren't there yet. They are working hard at it--rather, a lot of the biotech firms, with funds from the big pharma companies have been attacking the disease for the last decade from a variety of striking points. It has led to some innovations that have made treatment much better and have rendered certain kinds of cancers more of speedbump than a death sentence. That is wonderful, but not perfect, because of the suffering those people still must endure. It has saved lives, though.

The biggest problem is that cancers--even those that seem to be the same type of cancer--are very diverse. It's an unpredictable, out of control disease. Typically, they'd treat it by the location and how far developed it was (the stage). Newer research has been looking at the biology behind the different kinds of cancers they find and trying to find what drives it and what its weaknesses are. These are called targeted therapies. And approaching it that way, means two people with what 10 years ago they would have thought were the same cancer, may now receive entirely different treatments.

I have spent a lot of time on this--because it is personal, and I know so many people who have been affected by it. I also see it as an investment opportunity, and I ride a portfolio thick on biotech stocks. If you look at some of the smaller, smarter biotech firms trying to make strides in this area, they are doing things that weren't a possibility even 5 or 6 years ago. And they are attacking it in dozens of ways. It's all positive, because enough work is being done in enough areas, that they are stumbling onto things that work. One way is to look at different ways to help your immune system recognize cancer cells as invaders -- they now work with interferons, interleukins and there is a ton of work being done with monoclonal antibodies, which are things you inject into the body and attach to the cancer cell to help your immune system know what to attack. The research has been at times promising and discouraging, but it has been sloowwwwwwwww. It isn't from lack of will.

The targeted therapies are really interesting, and one area that is relatively new involves gene therapy -- something not possible before they mapped the human genone to the degree they have. Companies working on this believe that cancer cells are missing certain genes or have too much of others, and that makes the cancer grow out of control. Gene therapy research attempts to fix those problems by replacing missing genes, removing overactive genes. Other biotech companies are working on implanting genes that make the cancer cells particularly sensitive to chemotherapy, making it way more likely the chemo kills off the cancer for good.

One of the challenges they are facing deals with getting those genes in without destroying the healthy cells nearby. It's why this is all so complicated. There is some research being done in which they even use viruses that are modified to carry the gene, and introduce them into the body to deliver the genes into the cancer cells.

This stuff doesn't even scratch the surface of what is being done. The problem is they just don't have a great handle on cancer. Instead of the one disease, with one cause that most people conceive it as, it seems to be thousands of diseases, with thousands of causes, many of which we don't understand (or know about). It makes it a much tougher nut to crack than polio, which has one of three causes -- all viruses (making a vaccine the way you attack it).

I wouldn't hold your breath for a single cancer cure. But you should be more cognizant of the strides they have made, and how hard they are working on it. I invest in a bunch of biotech stocks trying to focus on this. Most will go nowhere. They have conviction about what they are doing, and they show progress in early research in petri dishes and with rats. Then they get to stage 1 or stage 2 testing (which the FDA requires) and it doesn't look as promising. And they go back to the drawing board. But, for example, if you think there is a giant conspiracy to keep cancer uncured, I think you are very wrong. Take a look at a company like Seattle Genetics, for example. Aside from them having their shit together, the stock price has actually done pretty nicely for me--I invested very early, before they showed some promising research that made the price boost. There was some Microsoft money behind the formation, including Bill Gates, who I believe is still an investor. They are relatively small, but they have placed their bets with monoclonal antibodies and have come up with several promising ones that may not exactly be classified as "cures," but when combined with chemotherapy, might take some "certain death" kinds of cancer and shift the odds in favor of the patient. They have one compound that looks promising for types of non-Hodgkins lymphoma and another for Hodgkin lymphoma that are pretty far along in the FDA approval process. They have another pretty far along in the research and which looks promising for certain types of leukemia.

The type of research they are doing wasn't even possible 10 years ago because the science is expanding so rapidly. So I understand the frustration, because cancer is the biggest blight affecting more people than anything else out there. It's just so complicated that I wish you understood that the fact that we can't lick all of these different kinds of cancers, which likely have thousands of causes that are not easily diagnosed, is not from lack of will. It's from lack of ability. If the drug companies could figure this out, though, it would benefit them. The money to be made would be staggering. When a cholesterol drug like lipitor -- and high cholesterol is not the potential death sentence in terms of your odds that many cancers are -- is a multibillion dollar dynamo that Pfizer rode for years to huge profits (same with Merck for Zocor, but to a lesser degree)-- it doesn't make sense to assume some conspiracy about cancer. If you could come up with an effective breast cancer treatment that you patented, your drug company could go on autodrive for seven years and all you'd have to do is hire accountants to count the money (although they are smart enough to keep doing the research or fund biotech companies to do the research to find the next wonder drug that will profit them 5 years down the road).

 

Dan, Those things aren't cancer, which is an "old" thing that has plagued humanity, with a zillion causes likely. When they discovered Viagra, for example, they were in early stage testing for a heart medication. They quickly figured out it wasn't going to do what they were testing it for, but it gave impotent men hard-ons. Conquering cancer is not going to happen that easily -- or by luck -- because cancer doesn't seem to be a single malady. The way they are treating it nowadays, suggests that if two people have what look like similar pancreatic cancer, for example, the ways to attack each of them most effectively might differ. The two seemingly similar cancers might not be the same thing. The mechanisms for what causes cancer are not even well understood. In the case of Polio, you were battling a virus. What are you battling in cancer and how many different diseases is it?

As to your first part, yeah, doctors overprescribe in this country and they sometimes order ridiculous tests that were at the least unnecessary. We have nothing in place discouraging them from doing so. If you have insurance, it is "free" to you. If you are relying on insurance for reimbursement, they are stiffing you with price-fixed schedules, so doctors have all the reason in the world to make back what they can by ordering up more tests or working with each other to refer patients to their specialist friends. It's how systems of intermediaries ruin health care--they take out the incentive to be cost conscious. I'm not sure there are many doctors knowingly ordering up tests or prescribing medicines that are harmful. Most doctors are good and go about their jobs the right way.

I'm not sure what "Big Medicine" is, but they will basically offer any medication that might be potentially profitable. The drug companies are in business to make money and the best way to do that is to offer a drug that can help the greatest number of people. The more serious the disease it addresses, the more necessary the drug is, which will also drive profits. By and large, they are hardly finding "new" things than can be cured with a pill. The biggest selling drugs actually reflect some of the most dangerous health hazards effecting the most people. Again, unlike cancer, these things are relatively easy to attack with research and new pills. The most profitable drugs in 2005 (what I found) were: Lipitor (chlolesterol medication made by Pfizer), Plavix (Bristol Myers, used to prevent heart attack and stroke), Nexium (used for heart burn and acid reflux, made by AstraZenaca), Advair, (Asthma medication made by Glaxo), Zocor (another cholesterol med, made by Merck), Norvasc, (Pfizer's other blockbuster drug, used to treat high blood pressure) and Zyprexa (Eli Lilly drug for schizophrenia and bipolar disorder). These are all multibillion dollar drugs. They have changed millions of lives for the better and extended life expectancies, especially when you take into account that many of the things they address--high blood pressure and cholesterol--are things that we have brought on ourselves with our increasingly more unhealthy lifestyles. Most people could control those things through diet and exercise and not smokng. Instead they are trying to rely on very expensive pills. At least we have the pills, because lord knows how many heart attacks and cases of diabetes and stroke we'd be dealing with without those medications, given how overweight and out of shape most of America is.

 

He seems to contradict himself. On the one hand, he criticizes the industry for being a one-trick pony that isn't that innovative, relying on "me too" drugs. He also criticizes the patent laws and perks Congress gives them, which they ride. As I was reading that, I was thinking about all the drugs that have gone off patent the last few years, and the several blockbuster drugs ready to go off patent, which has several of the largest pharmaceutical companies (and their investors) shitting their pants. He suddenly addresses this:

He undermines everything he had said in one paragraph.

Basically his argument seems to be that they have to keep coming up with SOMETHING (in his article, he argues that the NIH and smaller biotech firms do all of the innovating, but if you look at the money pharmaceutical companies are spending, they spend a lot on funding biotech research with future rights as the payoff). They also ARE counting on genetic research to yield the next generation of innovative drugs, something he alludes to, but seems to shrug off.

There is truth to what he is saying, but there are reasons why the marketing budgets of drug companies are so large. We have created a system in which they have no choice. With formularies and insurance companies controlling what gets prescribed in this country--not the best medicines--they need to wage a marketing war. You don't think they'd rather keep that money as profit rather than shit it away on advertising? It means getting consumers walking into their doctors offices asking about specific medicines and doctors having new medications they may be resistant to shoved down their throats (with samples and advertising and perks as inducements to get them to prescribe it). That kind of marketing work can make or break a drug. It can be the difference between a drug that benefits a lot of people actually making it or that same drug dying in oblivion. It's sad, but true. And it isn't the fault of the drug companies. They are playing the hand they were dealt.

I also love how he decries the drug company profits, but then slips in throwaway lines about how the industry as a whole ONLY spends about 14 percent of its profits on R&D at the same time that he is making the case that they seemingly do no R&D. That is a large percentage of profits to be putting back into the business to try to sustain itself. It's ridiculous to argue otherwise. When Lilly loses its patent on Prozac or AstraZenaca loses its patent on Prilosec or Schering-Plough loses its patent on Claritan or Bristol-Myers loses its patent on Glucophage, those are multi-BILLION dollar hits. Shareholders don't like those kinds of earnings hits. Which is all the incentive in the world for the drug companies to try to keep their pipelines flush with new drugs.

By and large, despite his circular article, which never argues with a word I am saying, those drug companies have managed to keep their pipelines filled -- with minor blips of a few years in which thinks have looked bleak for some of them. Yeah, they rely on private research and they ride the biotechs hard for innovation (why I encourage everyone to invest in an intelligently formed basket of biotech stocks). They still pay for that innovation, though, either by striking deals before drugs are FDA approved or paying fortunes to buy the drugs once they pass through their stage testing. It isn't like the drug companies get these drugs for free.

What exactly WAS his "alternative" view and why did he contradict what he was saying a half dozen times?

 

FYI, Don't get too excited. I have seen other stories that sound just as hopeful... There is a long way from his to treatments. But I always keep my eyes open to stories like this. It could spell biotech investment opportunities down the line, when these guys get their funding (and some extra money) from someone in return for the rights to whatever they come up with...

http://news.bbc.co.uk/2/hi/health/7161762.stm