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Cancer improvement rates, biomedical capital allocation

Source: https://ourworldindata.org/cancer#cancer-survival-rates

 

Cancer survival rates and cures have enormously improved over the last 40 years. From 5 out of 10,  5 year survival rates to close to 7 out of 10 5 year survival rates (although sadly not for pancreatic).

 

Much like the Hans Rosling Factfulness book argues, we should acknowledge how much better certain items are despite considerable challenges going forward.

 

I think there are some hard conversations to be had on the allocation of resources on aspects of innovation, especially towards very end of life care.

 

This you can sense from Atul Gawande’s book, Mortality (Gawande Mortality blog post ).  If someone is facing average survival of 3 to 6 months, and the tail chances of survival of eg. 2 years are extremely low then a balanced conversation is needed.

 

One parallel to this can be seen in the Biomedical Bubble paper. I have several critiques, which I haven’t the capacity to spell out properly here, but one of the central ideas could be epitomised by the notion of spending $1bn on development a treatment that increases survival, say  6-12 months, and is not a cure vs spending that money on prevention or other system innovations is a mis-allocation of capital. I think that argument has some validity - although the pricing of life and innovation is a tricky area particularly in second order insights and technology from biomedical research (and that plenty of biomedical cost is late stage and undertaken by private companies). Perhaps, that needs more input from philosophers (some of the basis of the UK’s NICE framework of pricing Quality Life Adjusted Years springs from this philosophy work and ideas of distributive justice, as well as the value/costs of road building - see Value of life, under constrained budgets )

 

Some provoking reads on health innovation in those above/below links.

Blog on Rosling data

World in Data - cancer data

Atul Gawande Mortality blog post

Biomedical Bubble paper

Value of life, under constrained budgets - see the work of philosopher Jonathan Wolff on a somewhat accessible look at this.

 


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