[donocco]

Nguygen

I am sorry your wife is having this problem. In the medical science world it is publish or perish. Its like the news. The more spectacular the headline the more attention the article gets. To use an analogy, here in California we get earthquakes. Sometimes they are serious. It is almost amusing to watch the local news scrambling to find someone that died during the earthquake so the headline can read " KILLER earthquake hits Southern California. Sometimes they get desperate and find someone who died in an area far from the epicenter. You wonder if the fatality is a 96 year old man who died in in his sleep but during the earthquake.

My main concern is the FDA. They want to keep their jobs. naturally, particularly with all of the power they have. In order to keep your job, you have to please your boss. This is unarguable. Congress made the laws that gave the FDA dictatorial powers. Congress is the boss of the FDA. The congressmen want lobby money for reelection. The drug companies are major lobbiests in the Health Care System. The more money they make the more Lobby money Congress gets. Its to the FDA's advantage from a job security point of view to approve as many drugs as possible.

In the days before insurance, people paid for their own meds. The price had to be affordable. Oral Zofran at 4 dollars a pill was the most expensive drug in 1987. Now the sky is the limit. The insurance companies probably encourage these high drug prices. It keeps people totally dependent on insurance coverage. In other words paying expensive premiums.

To use Time to progression increases as a reason to an oncologydrug is inexcusable. Time to
progression increases have little to do with increases in overall survival. Before the insurance takeover of medicine the drug companies had to produce useful drugs to make money. if we were back in 1987, the docs (who had private practices) would prescribe the breast cancer drug that kept the patients alive the longest. The drug company that produced the drug with the longest overall survival made the most money. It is a different story now. They can put any thing on the market and charge thousands per capsule. The IV PD-1 inhibitors cost 30,000 dollars a dose an d about 200 dollars to produce. This has to change if we are going to see real advances in cancer therapy. But how? A big question


Paul



Paul