The United States is running out of Methotrexate®, which is part of a drug cocktail that cures acute lymphatic leukemia in children. Why? Because there is not enough profit in manufacturing and distributing this drug and many other drugs for cancer and other diseases. Clearly the profit motive has trumped the social and humanitarian necessity of healthcare. And the amazing thing is that being healthy is cheaper! But it is only cheaper in an integrated system that includes prevention, early intervention, and carefully crafted programs for the very ill.
So what does this mean for finding a cure for myeloma? We need a new model, and the model must consider current economic constraints. In 1777, the Scottish economist and moral philosopher, Adam Smith, triggered our faith in the natural checks and balances of the free market system, but it appears that 235 years later, new approaches are needed.
10 STEPS TO FINDING AND SUSTAINING A CURE
1. To find a cure, we must truly look for approaches that have a dramatic impact- do not just move the ball a little bit forward.
2. This requires considering the unusual, the unexpected- the "Black Swan" or "Rainbow Toad" approach. We must be open to and foster creative thinking.
3. Collaboration, not competition, is key. This is the central aspect of the IMF's International Myeloma Working Group (IMWG). We hold annual brainstorming meetings (summits), during which we prioritize the best ideas for action steps. Small teams form to get projects rolling. Multiple projects are central to the goal of leaving no stone unturned.
4. Funding must be increased. The IMF has been blessed with many generous donors. To ensure that these innovative projects move forward rapidly, we will need to inspire like-minded individuals to increase their giving.
5. The IMF limits overhead costs and protects both patient privacy and intellectual property rights.
6. The IMF carefully considers the long-term financial implications of new treatments- for example, the potential for shared royalties.
7. If an FDA-approved generic drug (like Methotrexate) can do the job, we must be prepared for that and come up with creative solutions with shared responsibility and reimbursement.
8. If $100 million or more is required to make a new drug, let's plan ahead to achieve outcomes that are fair for all in the short term and long term. This is definitely the hardest part: to sustain investment and ultimately keep costs down.
9. New drug approval is key. An open dialogue with the FDA can enhance the approval of drugs that we need right now to keep patients alive as well as drugs that can achieve a paradigm shift in outcomes.
10. We must bring "health" and "caring" back into healthcare and work together to achieve it!
Dr. Brian G.M. Durie serves as Chairman of the International Myeloma Foundation and serves on its Scientific Advisory Board. Additionally, he is Chairman of the IMF's International Myeloma Working Group, a consortium of nearly 200 myeloma experts from around the world. Dr. Durie also leads the IMF’s Black Swan Research Initiative®.