Effective cancer-screening systems and the advancement of genome sequencing are key to reducing costs and the need for expensive treatments, a world-leading breast cancer expert said on Tuesday.
Billions of people remain priced out of quality cancer care as the cost of drugs continues to spiral upwards, leaving many without hope of recovering from a potentially fatal disease.
With no sign of a reduction in development costs, drugs to treat stomach and lung cancers can be up to $12,000 a month, while some leukaemia treatments are priced at more than $64,000 by manufacturers.
Speaking on the sidelines of Arab Health in Dubai, Prof Charles Coombes, professor of Medical Oncology at Imperial College London and director of the Cancer Research UK Imperial Centre, said developing a new drug can cost up to $1 billion.
“Pharmaceutical companies have to try to recoup that but they are not moving fast enough to ensure these disparities between different countries are broken down,” he said.
“Some drugs in use by the West for 10 years are still not available in poor and middle-income countries.
“This worsening of disparities is not being addressed.
“No matter how far prices are reduced, half the population will still never be able to afford them.”
One of the most expensive drugs to fight cancer is Kymriah, an antigen T-cell therapy used in children and young adults that costs about $475,000 for a single bout of treatment.
Like many other forms of cancer medication, the inequality of global care has created vast chasms in who has access to life-saving treatment.
Since 2013, Xofigo has been used to treat late-stage prostate cancer for about $12,600 a month, while Cyramza won FDA approval in 2013 to help doctors treat stomach cancer. Monthly costs are about $13,200.
Other cutting-edge drugs approved for late-stage lung cancer treatment include Zykadia ($13,600 a month) and Lenvima, used since 2011 for late-stage thyroid cancer at a cost of almost $14,000 a month to stop cancerous cells from replicating.
At about $64,000 a month, Blincyto helps a patient's immune system to destroy leukaemia cells in a small percentage of patients that develop a rare form of the disease.
Simple blood tests
Immuno-oncology drugs and targeted treatment for abnormalities in cells have become standard practice in the West in recent years but are available to fewer than 10 per cent of those living in the Middle East and North Africa, said Prof Coombes, who is also the Chair of The Imperial Cancer Research and Adviser to Abdul Latif Jameel Health.
“If you have an effective cancer screening system, you detect it earlier,” he said.
“If all women were called for breast cancer screening, that would be a big step forward and is tied to the cost of drugs.
“However, the cost of whole genome sequencing has fallen rapidly, to less than 1 per cent of the costs a decade ago.
“It will eventually become available to everyone.
“A blood test to determine which genes could make you more susceptible to some cancers will help identify who is more at risk.
“Rather than tell you if you have a one-in-eight chance of getting breast cancer, it would tell you if you had a one-in-four chance.”
Greater access to CAT scanning and ultrasound is helping doctors detect micro thyroid cancers that can be treated with minimal expense.
Due to better detection, it is fast becoming one of the most common UAE cancers.
“The majority of these cancers can be observed and don’t progress but others do,” said Dr Geoff Thompson, a consultant surgeon at Sheikh Shakhbout Medical City Abu Dhabi.
“If they are caught at the right time, they can be cured.
“Through a genetic test, we can identify this in children at a young age.
“If they have a mutation, we can do a surgery to stop them developing an aggressive form of this cancer.
“A small number of patients will regress and a new set of inhibitor drugs can be used in select cases but they are very expensive.”
Portable ultrasound device
Meanwhile, technology is helping to level the peaks of cancer care inequality by improving early diagnosis to reduce the need for expensive drugs.
Dr Maryam Ziaei has developed an automated, portable, 3D breast ultrasound that could significantly increase early detection after gaining FDA approval.
The wearable breast plate, which was on show at Arab Health, has a water vessel through which ultrasound is passed to detect abnormalities.
“I have lost friends through breast cancer because it was detected too late,” said Dr Ziaei.
“Access to screening is a global issue, so we looked at how we could bring small, portable ultrasound imaging to more women.”
The iSono Health compact device captures 3D images through automated scanning of the whole breast in only two minutes.
It is easy to use and costs around half that of a regular mammogram.
The device connects to a laptop or tablet for real-time 3D visualisation, while data is transferred to a secure cloud for storage.
“We wanted to make the experience better for women, as more than half in the US do not take regular screenings,” said Dr Ziaei.
“They can take time, so they put it off until they are in later stages [of cancer].
“If it is caught early, it can be treated well. Women should not be dying of breast cancer.”