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Observations

Opinion, arguments & analyses from the editors of Scientific American

Health Care Needs (More) Reform: Cancer Drugs Show How Markets Remain out of Whack

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http://upload.wikimedia.org/wikipedia/commons/thumb/9/97/Druppelcilinder_%281%29.JPG/240px-Druppelcilinder_%281%29.JPGThe market for at least one class of vital drug seems to have gone haywire. Certain types of generic cancer drugs are really hard to find. In August, of the 34 generic cancer drugs available to patients, there were 14 that could only be found with great difficulty. "If you are a pediatric oncologist, you know how to cure 70 to 80 percent of patients. But without these drugs you are out of business," wrote oncologist Ezekiel J. Emanuel last month in The New York Times.

While all of this is happening at the low end, the upper reaches of the market are just as crazy. One of the much-heralded drug approvals in recent years was a "cancer vaccine"—a drug to treat prostate cancer—that commands $93,000 and buys an average of four months for patients at an advanced stage of the disease. The problem with this treatment, called Provenge, is that there just aren't enough buyers. Doctors have to front the money before getting reimbursed. They're not getting paid back quickly enough, and so they are avoiding the drug. In the last week, in fact, the drug's maker, Dendreon, laid off a quarter of its workforce because physicians are not buying.

There's something wrong with this picture. Maybe relatively effective generic drugs should bear a higher price tag, and a drug regimen that costs as much as a small house in some parts of the country should be more affordable. In this case, the market seems to be sending a message that the current approach is unworkable. Unfortunately, the get-the-government-out-of-my-face ethos won’t solve it either.

Source: Wikimedia Commons

The views expressed are those of the author and are not necessarily those of Scientific American.

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