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Do cancer drugs improve survival or quality of life?

BMJ 2017; 359 doi: https://doi.org/10.1136/bmj.j4528 (Published 04 October 2017) Cite this as: BMJ 2017;359:j4528

Cost-effectiveness of cancer drugs hit rock-bottom but no action yet.

The skyrocketing prices for drugs have nothing to do with either economic realities (misrepresented cost of research, top ranking price-earning ratio …) or common sense (lack of relevant clinical benefit, scarcity of resources for the society…). Prasad, once more, as some others, showed evidence that the present system regulation is a devastating shame for cancer drugs.(1,2) The Journal has been raising serious concerns too for a long time, and they are not limited to cancer drugs.(3) However, no improvement yet.

Why are we looking for evidence again and again? The system is so inefficient and corrupted that 37% of Americans think the Food and Drug Administration intentionally suppresses natural cures for cancer because of drug company pressure?(4)

Worst, the 30th World Oncology Forum convened by the European School of Oncology in 2012 with the task of evaluating progress to date in the war against cancer concluded that current strategies for controlling cancer are clearly not working and issued a remarkable action plan: concise, only 10 actions, war on tobacco being the first.(5) Nevertheless, only one-half of patients with cancer who smoke are counselled to quit although smoking cessation is an important factor in the outcome (cancer treatment effectiveness, overall survival, risk of second primary malignancies, and quality of life).(6) Regulatory agencies are far from being the sole problem.

Hijacking a quote from Einstein may offer a cornerstone for solutions: “Problems cannot be solved with the same people that created or nurtured them.”

1 Prasad V. Do cancer drugs improve survival or quality of life? BMJ 2017;359:j4528.

2 Kim C, Prasad V. Cancer drugs approved on the basis of a surrogate end point and subsequent overall survival: An analysis of 5 years of US Food and Drug Administration approvals. JAMA Intern Med 2015;175:1992-4.

3 Counsell CE. Orphan drugs. Regulation is flawed. BMJ 2010;341:c7016.

4 Oliver JE, Wood T. Medical conspiracy theories and health behaviors in the United States. JAMA Intern Med. 2014. Published online Mar 17. doi: 10.1001/jamainternmed.2014.190.

5 The Lancet. Stop Cancer Now! Lancet 2013; 381: 426–27

6 Ramaswamy AT, Toll BA, Chagpar AB, Judson BL. Smoking, cessation, and cessation counseling in patients with cancer: A population-based analysis. Cancer 2016;122:1247-53.

Competing interests: No competing interests

10 October 2017
alain braillon
senior consultant
University hospital. 80000 Amiens. France