Cancer kills nearly 1600 Americans every day. In 2014, about 585,720 Americans will die of cancer, translating to almost one out of every four deaths in the United States.
As a country, we will spend $201.5 billion in health care costs to fight cancer and to provide treatment to the 1.6 million Americans who will be diagnosed this year.
Simply put, with these numbers, cancer impacts everyone.
Quality cancer solutions, then, require a partnership not just between patients and caregivers, not just between payers and providers, but in fact, among everyone. Improving outcomes and quality of life for cancer patients and their families is a massive undertaking that can be achieved only through substantive and cooperative investment from all health care stakeholders, including the biopharmaceutical industry, academia, health care payers, providers, patients, nonprofit patient organizations, employers and the public sector.
To respond to this challenge, the Cancer Innovation Coalition (CIC) has developed collaborative policy solutions that will facilitate innovation and promote novel approaches to foster the research and development of innovative cancer treatments. These approaches will benefit patients, reduce burden on the health care system, increase productivity and strengthen the economy at large while mitigating regulatory and financial hurdles. Above all, the goal of delivering innovative care to patients is paramount to ensure access to new and potentially life-saving treatments. Breakthroughs in cancer treatment bring tremendous personal value to patients and families, who are able to enjoy healthy and productive lives, and bring substantial economic value to our health care system.
The CIC has identified three necessary pillars of innovation:
Expanding on the Science of Innovation by Streamlining Logistical Obstacles
Between 1988 and 2000, life expectancy for cancer patients increased by approximately four years, which translates to about 23 million additional years of life and roughly $1.9 trillion in value added to the economy.
Since some therapies introduced in more recent years have shown better tolerability than traditional chemotherapy, the quality-adjusted life benefit could be even greater.
Society must sufficiently value and reward progressive, step-wise innovations as well as breakthroughs so that advances in breast cancer and colon cancer research can be replicated across all tumor types. Progressive gains lead to breakthrough treatments.
To ensure optimal advances in cancer therapies, both progressive and breakthrough, logistical, bureaucratic, institutional and regulatory obstacles to innovation must be reduced to the greatest extent possible. Documentation and auditing mandates, divergent local institutional review board (IRB) requirements for consent forms and protocols, duplicative and conflicting standards, increasing regulatory requirements and delays in review decisions are often unnecessarily burdensome without providing an additional measure of safety for study subjects or a commensurate gain in the quality of clinical research. Clearing such hurdles will require a nationwide strategic plan among all stakeholders to establish priorities and coordinate uniform, or at least coherent, requirements among research institutions and across government agencies.
Improving the Value of Innovation by Bolstering Funding Opportunities
Investment in medical innovation will improve health care outcomes for patients and lower long-term health costs, relieving financial pressures on federal programs such as Medicare and Medicaid, and lowering costs borne by employers for the health care of their employees. However, these benefits will require all stakeholders to make a solid financial commitment to medical innovation. This commitment will necessitate increased funding for basic and clinical study – particularly through Congressional appropriations for government research – and heightened awareness by all stakeholders of clinical research opportunities. Public and private sector stakeholders need to be united in their dedication to fund the basic research that provides the foundation for the discovery of innovative treatments and therapies.
The significant, sustained research in basic life sciences led by the National Institutes of Health (NIH) is critical to the biomedical ecosystem and the Food and Drug Administration (FDA) plays a critical role in finding creative ways to promote and review medical innovation. However, further government investment is needed to increase the transparency, efficiency and effectiveness of these agencies while mitigating regulatory impediments.
Enhancing Delivery of Innovation through Improved Communication and Coordination Between Providers and Patients
By enhancing enrollment in clinical trials, we will ensure that medical science advances as expeditiously as possible and that patients obtain access to cutting-edge cancer treatments that are affordable, albeit experimental. To realize these benefits, physicians must be aware of clinical trials being planned and conducted, and they must share that information with their oncology patients for whom such trials are appropriate. Coordination among oncology researchers, treating oncologists and patients is essential so that all parties are educated about ongoing research.
In addition, regulatory policies must be established to ensure that payers cover clinical trial costs for patients, as required in statute and Executive Order. Payment and reimbursement for treatments must be adequate and timely, and cost sharing must be kept at a level that ensures access will not be unduly limited. Delivering innovative cancer medications in this manner can result in better outcomes and better quality of life for patients, advance cancer research and alleviate some of the long-term financial strain on our health care system.
In summary, the biggest obstacles to expanding research for cancer treatments, particularly new drug therapies, is the substantial research and development costs that must be incurred by pharmaceutical manufacturers, providers and other private research institutions in developing potential treatments. There is very little governmental or publicly funded cancer research currently in the United States. Rather, the overwhelming majority of all cancer research and development is undertaken by private entities. The CIC recommends that to alleviate these obstacles federal and state entities invest in more research, perhaps in tandem or in collaboration with pharmaceutical manufacturers and other public and private entities while developing incentives for innovative research. We also recommend that the federal government develop incentives to urge collaborative efforts among pharmaceutical companies and other researchers. In addition, the CIC recommends that patient access to clinical trials be expanded by the federal government and that there be better publication of the availability of clinical trials in order to boost enrollment. Lastly, the CIC urges the federal government to continue to work on expedited regulatory pathways through the FDA so that potentially life-saving treatments can reach otherwise terminal patients faster.
Throughout our nation’s history, public and private stakeholders have joined forces to tackle some of the world’s largest health crises, notably polio, CML, testicular cancer, lung cancer, childhood leukemia and HIV. Melanoma, a form of skin cancer, is the latest example of a tumor type to see an increase in treatment options available due to innovation in cancer treatments, such as targeted drugs, surgeries, and immunotherapies.
Today, thanks to biomedical innovation, most patients diagnosed CML during the chronic period can look forward to a life expectancy similar to a non-CML patient. However, it took about 30 years of basic scientific research and progressive treatments to allow for this breakthrough therapy for CML patients. We can do better together.
Meaningful advances in cancer therapy will happen only through policies that recognize the unique role that medical innovation plays in improving the lives of Americans. Stakeholders must work together to sustain investment in innovation that will expedite research and development, regulatory review and approval processes, without sacrificing safety and efficacy.