The vaccine works by instructing the body to make up to 34 “neoantigens.” These are proteins found only on the cancer cells, and Moderna personalizes the vaccine for each recipient so that it carries instructions for the neoantigens on their cancer cells.
Which is why the Moderna vaccine will be priced at just 95% of the cost of the repeat treatments and hospitalization plus the value of the time saved and pain and suffering avoidance by the patient. Say, an extra half a million. I mean, what price would you put on avoiding seeing your parent or child subjected to round after round of chemotherapy?
Depends on how much time was spent on R&D. You have to recover those costs. I know everyone wants everything for free but it takes a fuck ton of man hours and tons of investments to get to this point. You can’t just give it away unfortunately.
I like to shit on big pharma as much as the next guy, but in this case, yes they do. Developing new drugs is a ludicrously risky and expensive venture, typically costing billions of dollars. Sometimes it may be subsidized somewhat, sure, but the vast majority of it is coming out of pocket for these companies.
Sometimes it may be subsidized somewhat, sure, but the vast majority of it is coming out of pocket for these companies.
You seem awfully sure about that. What are you basing it on? MRNA research alone was massively funded with taxpayer money. Coding for new proteins is almost trivial compared to what went into developing the technology.
You actually can. The simplest way is to literally just give the research away and charge a fair price for the medicine. That’s allowed.
The slightly more capitalist way would be to sell the rights to the government to recoup costs.
The slightly less capitalist way is for the government to notify you that you don’t own it anymore because of the public good.
This is also ignoring exactly how much the public already funds the basic research that goes into pharmaceuticals, which is quite a bit more than you might expect, so the argument of what’s even “fair” is less clearly in favor of the company than you might expect.
For every endeavor that could recoup its costs in a fairly reasonable way, there are several other attempts that end in failure.
If you know that best case your project can be modestly better than break even, but it will most likely completely fail, would you invest in it?
I could respect an argument for outright socializing pharmaceutical efforts and rolling the needs into taxes and cutting out the capitalist angle entirely, but so long as you rely on capitalist funding model in any significant amount, then you have to allow for some incentive. When the research is pretty much fully funded by public funds, that funding should come with strings attached, but here it seems the lead up was largely in capitalist territory.
I use to agree with you but that metric sailed a long to me ago. All pricing, everywhere now, is based on how much they think people will pay, not cost plus a reasonable profit.
A $1300 iPhone probably cost around $200 to actually produce, and that covers development.
Any cost savings on production, or cheaper materials, is profit passed on to the stockholder. It does not go to workers and certainly does not go to a cheaper sales price.
Nearly all of the basic research is already taxpayer funded through research grants. There are still development costs (especially trials and such), but most of the money spent my large pharmaceutical companies goes into marketing. (it’s been a few years, but last time I looked in the mid-teens it was more than 50% of their overall budget iirc)
You’re not going to get a sympathetic ear around here. Lemmy wants everything for free. Bunch of children watching capitalism literally burn the world down, but has no clue that nice things cost effort, and effort = $.
Now if you want to talk about making drug advertisements illegal, I’m all in. Wouldn’t that make a wonderful impact? Make big pharma put the money into R&D that they put into ads.
That’s what my taxes are for. I rarely pay more than $5 for medication, if anything. I also pay significantly less in taxes than US citizens and have less potholes in the roads.
So if this happens exactly as you describe, the net result will be a cancer treatment that is way more reliable and causes way less suffering than the existing treatments, and is slightly cheaper to boot?
That sounds awesome!
In reality they’ll likely reduce the price more than that, because the balance between the supply/demand curve will likely give them even more profit if they drop it down farther. More people will be able to afford it so it’ll create a bigger market. And then in a few years competitors will start coming out with their own mRNA cancer treatments and competition will start pushing it down even more.
No it will be more expensive. The pricing would be based on how much it currently costs, priced competitively (95% of, say, $500,000) and then they’d add $500,000 to account for the fact that you would recover more of your life and avoid suffering, so $950k total. Of course they may simply price is based on the value of your life. Say the average value of a human is $1.5M in a typical wrongful death suit; they might price it at $1.25M - a bargain!.
Before you laugh at my logic, I’ll point out that Luxturna priced their retinal degeneration drug based on how much value courts placed on lost eyesight. They found that to be around the million-dollar range. The price of treatment was then set at $850,000, because that’s clearly providing value over the monetary equivalent of loss of eyesight (Jeffrey Marrazzo, CEO, was quoted in an interview that this was the basis). Of course, there’s an evilly fun MBA discussion to be had, as well, as your pricing could also be how much it’s worth to a parent not to have to watch their children slowly and unavoidably go blind as they become teenagers. Other drugs are often based on the cost avoidance or value of human life of 100-150k per year, and I’m sure they will argue that a cure should account for the entire life amortization of such a cost. Maybe it will be $5M for someone in their 20s, but only $500k for someone in their 70s.
If this is how they price these things, then why wasn’t cancer treatment already $1.25M? Did they only just now realize how much they could squeeze out of people?
Luxturna’s treatment is for a very rare form of blindness. Unfortunately treatments for rare diseases tend to be very expensive because of how R&D and the market works, there’s much less opportunity to spread out the cost and mass production never happens. Melanoma is not a rare disease, unfortunately quite the opposite. Cancer in general even less so.
In many cases,in the US, the rack rate for a full course of a serious cancer is easily the $500k I suggested and frequently more than double that. My treatment for a suspected single point melanoma was close to $75,000 and it was a single outpatient procedure with a pre- and post-op office follow up. No chemo, no stage designation, nothing - zero cancer found at the site of the questionable biopsy site.
It’s true the Luxturna is an odd case (though the OP article is talking about customized treatment so it is appropriate here). It’s not the disease or cure but the justification of how they determined the cost of their treatment. Not based on the research cost or market, not based on the production or application of the treatment, but on the value of your eyesight they would be preserving.
It’s not better, ideally the body finds and eliminates cancer cells all by itself. Just like it does with viruses or infection. It happens all the time, most of the time you’d never know it happened
What this does is hardcore the “solution” into your immune cells. It tells them exactly what antibody to build, and spams that knowledge, so your immune cells are loaded up and ready to use that antibody
Exactly. And ideally not just cells growing out of control, cancerous or not. Senescent cells that no longer perform their function too - they all have bio markers that are missed.
If we could buff up elimination of cells no longer fulfilling their function, and introduce various revitalized stem cells? That’s how you live to 200 baby. That’s rejuvenation- it doesn’t fix plaque in your arteries or structural defects, but I’m convinced it would buy you a lot of time, alongside treating the symptoms
And that gives you plenty of time for us to figure out the biomorphic field and gets you to eternal youth and body mods… That vein of science works on simple life, but mammals are complicated. It didn’t take much to figure out amphibian xenobots, but we’ll probably reach AI superintelligence before we figure out how to flesh sculpt with human tissue… We’re a lot more delicate
I get this sounds insane to most people, but there’s legit science behind my beliefs, and I can look up specific evidence on request… Just be specific with what you want further reading on, it’s a complex topic
I think “reasonable” is doing a lot of heavy lifting here. Whatever price they charge it will be to maximize to Moderna’s profits - i.e. they’ll price it slightly lower than what insurers / national health systems would be stung for what 44% of melanoma patients needing a second round of expensive chemo would cost them but not so high that no one will cover the treatment. So I guess the price is “reasonable”, in that it’ll be cheaper than the alternative but it’s not like Moderna will be charitable or fair about it.
Yeah you see this with a lot of monoclonal antibody treatments that private companies develop. They price them insanely high to recoup the insane research costs, a lot of them have reimbursement programs for patents who couldn’t afford to take the drug, or who’s insurance can’t cover all of the drug, because they want a patient base as it adds value for their product. What happens in sane countries is you have healthcare boards negotiating prices with drug manufacturers to bring the cost down, and insurance or public plans covering what the most long-term cost effective and beneficial treatments are. Drug companies want to recoup their costs sunk in to research, and they want a patient base that can affirm the validity of the product.
Where I have a major problem is when private companies benefit from publicly funded research, or for private drug manufacturers who are merely producing single-molecule or bio-similar compounds for generic labels. IMO generic drug production should be publicly owned, as should products developed using public research grants. I would also do away with private insurance and tax schemes and use market simulation models to determine costs and efficiencies within a publicly owned framework. Small private specialty clinics I would maintain as well as research grants to private research but bringing the drug to market would be socialized and the private research institution reimbursed through that. Any essential, standardized treatments, would effectively be delivered in a fully socialized way, with smaller specialty areas being more economically “free” but in service to the broader socialized model.
Also sounds very hard to do a proper controlled trial on. Every treatment produces a different protein, so there’s no consistent factor to test except for the delivery mechanism.
There’s still ways but not trivial. You have to do multifactor analysis, but it’s gonna have a ton of noise unless you have a large sample of different people with recurring “neoantigens”. It’s similar to how drug side effects are tracked for people who take multiple medicines, you compare against populations which share different combinations of the same factors.
Multifactor analysis still requires an underlying commonality. People taking multiple drugs are all still taking the drug being trialed. You’re removing the confounding factors. If every treatment is a unique cancer protein there is no common factor. The treatment is the confounding factor.
To put it another way. A safety trial has to prove that any protein administered is safe.
Edit: just realised you’re probably talking about efficacy trials, whereas I’m more concerned with safety.
I worked for one the first hospitals that was doing genomic testing for oncology patients in the U.S. I am not advocating against genomic testing or precision medicine, but Amerisource Bergen, (at the time) McKesson, and the sales people at the manufacturer were licking their chops at the thought of precision medicine. It was extremely lucrative for some improvements on QoL. I sincerely hope that it’s not cost prohibitive to patients and results in breakthroughs in treatment. But I did watch as a lung cancer drug was administered to patients at the cost of 250k per treatment. I don’t remember how many treatments there were but the cost was insane. The US system of healthcare is absolutely broken and I believe there’s a study that particularly evaluated cancer as a major cause of families depleting whatever savings they had within a couple years of being diagnosed. This is an indictment of the whole system. Not the efficacy of the drugs.
Most modern cancer drug treatment is sequenced to at least the specific proteins of the type of cancer it is.
Have breast cancer? Cool. We figure out which of the many variations so that we can give you medications for that exact type of breast cancer.
This sort of specific targeting has been increasing and increasing for the last 20 years. MRNA is the next step of that and is highly likely to be a means or become or for treatments in many other areas.
That’s pretty dope
You mispelled “expensive.”
He must be one of those non-Americans with universal healthc*re
But… But everyone having a right to medical care whether they’re rich or poor? Unthinkable! Think of the shareholders!
Ew, I can feel myself getting healthier just parsing the word “u******l a***r”. You need to censor more of that.
That sounds like SoCiAliSm!!!
I doubt that this vaccine will be covered by European health insurance providers if it costs a lot.
I wonder if, even at this early stage of the therapy’s development, this would actually be more affordable than the alternative.
Melanoma patients are highly likely to have the cancer come back and or metastasize. Repeat treatments and hospitalizations are not cheap.
Which is why the Moderna vaccine will be priced at just 95% of the cost of the repeat treatments and hospitalization plus the value of the time saved and pain and suffering avoidance by the patient. Say, an extra half a million. I mean, what price would you put on avoiding seeing your parent or child subjected to round after round of chemotherapy?
Depends on how much time was spent on R&D. You have to recover those costs. I know everyone wants everything for free but it takes a fuck ton of man hours and tons of investments to get to this point. You can’t just give it away unfortunately.
Did they pay for their own R&D? Usually that get socialized and then the profits are privatized, it’s the American Way.
I like to shit on big pharma as much as the next guy, but in this case, yes they do. Developing new drugs is a ludicrously risky and expensive venture, typically costing billions of dollars. Sometimes it may be subsidized somewhat, sure, but the vast majority of it is coming out of pocket for these companies.
You seem awfully sure about that. What are you basing it on? MRNA research alone was massively funded with taxpayer money. Coding for new proteins is almost trivial compared to what went into developing the technology.
https://healthpolicy-watch.news/u-s-government-invested-31-9-billion-in-mrna-vaccine-research-and-procurement/
You actually can. The simplest way is to literally just give the research away and charge a fair price for the medicine. That’s allowed.
The slightly more capitalist way would be to sell the rights to the government to recoup costs.
The slightly less capitalist way is for the government to notify you that you don’t own it anymore because of the public good.
This is also ignoring exactly how much the public already funds the basic research that goes into pharmaceuticals, which is quite a bit more than you might expect, so the argument of what’s even “fair” is less clearly in favor of the company than you might expect.
There’s a tricky balance.
For every endeavor that could recoup its costs in a fairly reasonable way, there are several other attempts that end in failure.
If you know that best case your project can be modestly better than break even, but it will most likely completely fail, would you invest in it?
I could respect an argument for outright socializing pharmaceutical efforts and rolling the needs into taxes and cutting out the capitalist angle entirely, but so long as you rely on capitalist funding model in any significant amount, then you have to allow for some incentive. When the research is pretty much fully funded by public funds, that funding should come with strings attached, but here it seems the lead up was largely in capitalist territory.
I use to agree with you but that metric sailed a long to me ago. All pricing, everywhere now, is based on how much they think people will pay, not cost plus a reasonable profit.
A $1300 iPhone probably cost around $200 to actually produce, and that covers development.
Any cost savings on production, or cheaper materials, is profit passed on to the stockholder. It does not go to workers and certainly does not go to a cheaper sales price.
Would somebody think of the poor pharmaceutical executives?
Yeah; it’s not like it’s insulin.
True, but individuals dont have to pay for that. This is 100% something that can be taxpayer funded as it pretty much benefits everyone.
Otherwise, it just becomes a penalty for poor people and another luxury for the rich.
Nearly all of the basic research is already taxpayer funded through research grants. There are still development costs (especially trials and such), but most of the money spent my large pharmaceutical companies goes into marketing. (it’s been a few years, but last time I looked in the mid-teens it was more than 50% of their overall budget iirc)
You’re not going to get a sympathetic ear around here. Lemmy wants everything for free. Bunch of children watching capitalism literally burn the world down, but has no clue that nice things cost effort, and effort = $.
Now if you want to talk about making drug advertisements illegal, I’m all in. Wouldn’t that make a wonderful impact? Make big pharma put the money into R&D that they put into ads.
That’s what my taxes are for. I rarely pay more than $5 for medication, if anything. I also pay significantly less in taxes than US citizens and have less potholes in the roads.
So if this happens exactly as you describe, the net result will be a cancer treatment that is way more reliable and causes way less suffering than the existing treatments, and is slightly cheaper to boot?
That sounds awesome!
In reality they’ll likely reduce the price more than that, because the balance between the supply/demand curve will likely give them even more profit if they drop it down farther. More people will be able to afford it so it’ll create a bigger market. And then in a few years competitors will start coming out with their own mRNA cancer treatments and competition will start pushing it down even more.
No it will be more expensive. The pricing would be based on how much it currently costs, priced competitively (95% of, say, $500,000) and then they’d add $500,000 to account for the fact that you would recover more of your life and avoid suffering, so $950k total. Of course they may simply price is based on the value of your life. Say the average value of a human is $1.5M in a typical wrongful death suit; they might price it at $1.25M - a bargain!.
Before you laugh at my logic, I’ll point out that Luxturna priced their retinal degeneration drug based on how much value courts placed on lost eyesight. They found that to be around the million-dollar range. The price of treatment was then set at $850,000, because that’s clearly providing value over the monetary equivalent of loss of eyesight (Jeffrey Marrazzo, CEO, was quoted in an interview that this was the basis). Of course, there’s an evilly fun MBA discussion to be had, as well, as your pricing could also be how much it’s worth to a parent not to have to watch their children slowly and unavoidably go blind as they become teenagers. Other drugs are often based on the cost avoidance or value of human life of 100-150k per year, and I’m sure they will argue that a cure should account for the entire life amortization of such a cost. Maybe it will be $5M for someone in their 20s, but only $500k for someone in their 70s.
If this is how they price these things, then why wasn’t cancer treatment already $1.25M? Did they only just now realize how much they could squeeze out of people?
Luxturna’s treatment is for a very rare form of blindness. Unfortunately treatments for rare diseases tend to be very expensive because of how R&D and the market works, there’s much less opportunity to spread out the cost and mass production never happens. Melanoma is not a rare disease, unfortunately quite the opposite. Cancer in general even less so.
In many cases,in the US, the rack rate for a full course of a serious cancer is easily the $500k I suggested and frequently more than double that. My treatment for a suspected single point melanoma was close to $75,000 and it was a single outpatient procedure with a pre- and post-op office follow up. No chemo, no stage designation, nothing - zero cancer found at the site of the questionable biopsy site.
It’s true the Luxturna is an odd case (though the OP article is talking about customized treatment so it is appropriate here). It’s not the disease or cure but the justification of how they determined the cost of their treatment. Not based on the research cost or market, not based on the production or application of the treatment, but on the value of your eyesight they would be preserving.
It’ll be reasonably expensive, but sequencing and gene alteration is way cheaper than in needs to be.
If this can actually cure cancers, it may even be worth it.
The thing is, surely there’s antibody against cancer antigens anyway, in ordinary cancer. A cancer cell expresses epitopes not on healthy cells.
Why is this better?
…what? this sounds like you’re advocating for price increases.
Oops, new to Lemmy. But not new to typing, so no excuse.
I meant than “it used to be”.
I blame autocorrect.
It’s not better, ideally the body finds and eliminates cancer cells all by itself. Just like it does with viruses or infection. It happens all the time, most of the time you’d never know it happened
What this does is hardcore the “solution” into your immune cells. It tells them exactly what antibody to build, and spams that knowledge, so your immune cells are loaded up and ready to use that antibody
Yeah like we have cancerous cells in our bodies all the time, it’s when our immune system isn’t dealing with them that it becomes a growth or tumor.
Exactly. And ideally not just cells growing out of control, cancerous or not. Senescent cells that no longer perform their function too - they all have bio markers that are missed.
If we could buff up elimination of cells no longer fulfilling their function, and introduce various revitalized stem cells? That’s how you live to 200 baby. That’s rejuvenation- it doesn’t fix plaque in your arteries or structural defects, but I’m convinced it would buy you a lot of time, alongside treating the symptoms
And that gives you plenty of time for us to figure out the biomorphic field and gets you to eternal youth and body mods… That vein of science works on simple life, but mammals are complicated. It didn’t take much to figure out amphibian xenobots, but we’ll probably reach AI superintelligence before we figure out how to flesh sculpt with human tissue… We’re a lot more delicate
I get this sounds insane to most people, but there’s legit science behind my beliefs, and I can look up specific evidence on request… Just be specific with what you want further reading on, it’s a complex topic
I think “reasonable” is doing a lot of heavy lifting here. Whatever price they charge it will be to maximize to Moderna’s profits - i.e. they’ll price it slightly lower than what insurers / national health systems would be stung for what 44% of melanoma patients needing a second round of expensive chemo would cost them but not so high that no one will cover the treatment. So I guess the price is “reasonable”, in that it’ll be cheaper than the alternative but it’s not like Moderna will be charitable or fair about it.
It’s still an amazing breakthrough though.
Yeah you see this with a lot of monoclonal antibody treatments that private companies develop. They price them insanely high to recoup the insane research costs, a lot of them have reimbursement programs for patents who couldn’t afford to take the drug, or who’s insurance can’t cover all of the drug, because they want a patient base as it adds value for their product. What happens in sane countries is you have healthcare boards negotiating prices with drug manufacturers to bring the cost down, and insurance or public plans covering what the most long-term cost effective and beneficial treatments are. Drug companies want to recoup their costs sunk in to research, and they want a patient base that can affirm the validity of the product.
Where I have a major problem is when private companies benefit from publicly funded research, or for private drug manufacturers who are merely producing single-molecule or bio-similar compounds for generic labels. IMO generic drug production should be publicly owned, as should products developed using public research grants. I would also do away with private insurance and tax schemes and use market simulation models to determine costs and efficiencies within a publicly owned framework. Small private specialty clinics I would maintain as well as research grants to private research but bringing the drug to market would be socialized and the private research institution reimbursed through that. Any essential, standardized treatments, would effectively be delivered in a fully socialized way, with smaller specialty areas being more economically “free” but in service to the broader socialized model.
You pay tax. Tax is for roads, schools, and hospitals. Why don’t you get healed when you’re sick? Because you’re a sucker, bro.
Also sounds very hard to do a proper controlled trial on. Every treatment produces a different protein, so there’s no consistent factor to test except for the delivery mechanism.
There’s still ways but not trivial. You have to do multifactor analysis, but it’s gonna have a ton of noise unless you have a large sample of different people with recurring “neoantigens”. It’s similar to how drug side effects are tracked for people who take multiple medicines, you compare against populations which share different combinations of the same factors.
Multifactor analysis still requires an underlying commonality. People taking multiple drugs are all still taking the drug being trialed. You’re removing the confounding factors. If every treatment is a unique cancer protein there is no common factor. The treatment is the confounding factor.
To put it another way. A safety trial has to prove that any protein administered is safe.
Edit: just realised you’re probably talking about efficacy trials, whereas I’m more concerned with safety.
Personalized medicine is a way to rob you blind. Drugs cost unreal money. So does the hospital administration.
deleted by creator
I worked for one the first hospitals that was doing genomic testing for oncology patients in the U.S. I am not advocating against genomic testing or precision medicine, but Amerisource Bergen, (at the time) McKesson, and the sales people at the manufacturer were licking their chops at the thought of precision medicine. It was extremely lucrative for some improvements on QoL. I sincerely hope that it’s not cost prohibitive to patients and results in breakthroughs in treatment. But I did watch as a lung cancer drug was administered to patients at the cost of 250k per treatment. I don’t remember how many treatments there were but the cost was insane. The US system of healthcare is absolutely broken and I believe there’s a study that particularly evaluated cancer as a major cause of families depleting whatever savings they had within a couple years of being diagnosed. This is an indictment of the whole system. Not the efficacy of the drugs.
But isn’t personalized treatment kind of key to treating cancer?
Most modern cancer drug treatment is sequenced to at least the specific proteins of the type of cancer it is.
Have breast cancer? Cool. We figure out which of the many variations so that we can give you medications for that exact type of breast cancer.
This sort of specific targeting has been increasing and increasing for the last 20 years. MRNA is the next step of that and is highly likely to be a means or become or for treatments in many other areas.