The "Hotel Melanoma" moniker is a metaphor for living with my particular brand of cancer. Except for those lucky few of us deemed "cured", all we cancer survivors are guests of one of the many, many branded hotels in the "Hotel Carcinoma" chain. We can check out any time we like, but we can never leave. Meanwhile, let's be livin' it up; and please support cancer education, prevention, and treatment research.

Tutu Brothers

Tuesday, December 27, 2011

The Best of Your Drugs

Melanoma treatment is horrendously expensive, as my insurance company found out in 2003 when, thank goodness, it (eventually) agreed to pay for 20-some days of inpatient biochemotherapy. A contemporary case in point is Yervoy. It costs the whopping sum of $30,000 per dose, and $120,000 for the standard 4-dose course of treatment. I’m not here to defend the high price tag Bristol-Myers Squibb has placed on Yervoy, but I think the price has a whole lot to do with the many years and millions of bucks in research and development costs involved in bringing a new cancer treatment drug to market with FDA approval.

According to a BMS press release, the FDA’s approval of Yervoy in March, 2011 for treatment of Stage IV melanoma was the result of fourteen years of research and development. The FDA put Yervoy on its “fast track” approval process in 2006, but it still took another five years for the drug to receive approval. During that time, how many Stage IV melanoma patients died who might have benefited from Yervoy but didn’t receive it because they weren’t enrolled in one of the clinical trials?

BMS acquired ownership of Yervoy (Ipilimumab) in 2009, through a $2.1 billion acquisition of a smaller pharmaceutical company named Medarex. It’s been reported that Medarex’s research and development costs for Yervoy through its acquisition in 2009 were just over $300 million. How much additional money BMS spent to bring Yervoy to FDA approval in March, 2011 is, from what I’ve read, a number deeply buried in BMS’ financial statements, which don’t break out research and development costs for individual drugs.

I wish I knew how to make it a whole lot less time-consuming and expensive to make a new treatment drug like Yervoy available to all who might benefit. Somehow, I just can’t believe this is an insoluble problem. As a melanoma patient, I’m not sure I need or want any overzealous protection from the FDA-- because I’m willing to accept the risks that a treatment might kill me and that its effectiveness is promising but unproven when it’s almost certain that the disease will kill me if left untreated or treated by some other drug that is known to be ineffective. I’ve done that once already and I’d bet I’d do it again in a heartbeat. But all I know for sure is that as long as it takes fourteen years and hundreds of millions of dollars to develop a new melanoma treatment I’ll pray that I never find myself uninsured.

I’ll end this rant with my version of The Eagles’ “Best of My Love”…

Every night I'm lyin' in bed
Holdin' C close in my dreams
Thinkin' about all the things my doc said
And comin' apart at the seams
We try to talk C over
But the words come out too rough
I know he is tryin'
to get me the best of all drugs

Critical cases in loud clinic places
Look at the days that we’ll give
Wastin' our time on research so fine
Left us so little to live
That old drug crowd
Was like a cold dark cloud
That we could never rise above
And here in my heart I wish you the best of all drugs
Oh C doctor I want the best of all drugs, oh
C doctor, I want the best of all drugs

I'm goin' back in time
And it's a sweet dream
Out in the UV light
But I should be all right
If I just go on screenin'
But every mornin'
I wake up and worry
What's gonna happen today
C sees it its way
And I see it mine
But we both see it chippin' away

You know we’ll always have each other Black C
I guess that’s more than enough
Oh, and here in my heart
I wish you the best of all drugs
Oh, C doctor
I want the best of all drugs
Oh, C doctor
I want the best of your drugs
Every night and day,
I want the best of your drugs
Oh, C doctor we need the best of all drugs
Oh, C doctor we need the best of all drugs..

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