Woke up on New Year morning to read an article in the Hindu about a hospital in Coimbatore distributing a 'life saving' drug for kidney and liver cancer in conjunction with a pharmaceutical company.
The Hindu : Cities / Coimbatore : A life-saving New Year gift for cancer patients
The drug in question 'Sorafenib' has been much in the news in India mainly due to controversy regarding its high costs that has prompted the government of India to allow compulsory licensing to manufacture the drug at lower costs to generic manufacturers in India.
While I may be accused of being a cynic staring a hobby horse in the mouth, I would like to know why such largesse is not extended to other molecules that are effective in much more prevalent cancers in this country. Much larger numbers of patients in this country fall prey to oral, cervical, breast, hematologic and gastrointestinal cancers than kidney or liver cancers. However no such largesse or benevolence seems to be in view with regard to those drugs.
I hold no brief for the original manufacturers of sorafenib, but it does seem a witch-hunt to single out this molecule for compulsory licensing in order to control costs. One cannot but suspect vested interests behind the move. If such efforts are applied across the board to all cancer drugs, I will be one of the first to welcome and applaud it.
Sorafenib is a drug that inhibits an enzyme that controls intracellular signalling pathways in liver and kidney cells and has been shown to have some effect on patients with primary liver cancer. In the only large trial (SHARP) testing the efficacy of sorafenib in primary liver cancers, patients on sorafenib had their life prolonged by a few months over those that did not receive sorafenib. So to indeed call the drug 'life-saving' is a bit exaggerated based on current evidence. Of course prolongation of life by a few months can be a great deal of comfort for the patient with advanced liver cancer but it must be clearly understood that current evidence does not support the use of drug as a curative measure....hence as the best available evidence stands today the drug is a 'life-prolonging' and not 'life-saving' drug.
The drug once started has to be continued life-long. It is not clear whether this free dole promised to patients will be continued for their life or whether after sometime patients will have to purchase the drug. The article seems silent on this.
The drug no doubt could have potential in combination with other potentially curative treatments like resection or transplantation but this potential has not yet been proven in published literature. The use in these circumstances is investigational and success based on anecdotal reports or single centre studies.
Therefore gimmickry and misplaced populism seems to be the order of the day in such events.
I wish better sense will prevail among those planning such doles and those clamouring for them.
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