Op-ed views and opinions expressed are solely those of the author.
The future will belong to the country that can keep its people healthy and productive for as long as possible. Since at least the end of World War II, that country has been the United States. Our scientists and policymakers have driven health breakthroughs that have made us the healthiest, wealthiest, longest-living society ever.
But that could change, unless it is American medicine that wins the fight to eliminate cancer. And the Chinese are trying to get the jump on us.
Look at what is happening right now with the efforts to import masks and gowns from China to help protect doctors from the coronavirus.
Chinese drugmakers are also racing to find a way to produce a drug to protect from infection and to treat the symptoms of the virus. The problem is that with these efforts to find the drug to fight the coronavirus, the Chinese cut corners and don’t do as much testing as we do here in the U.S. We need to win the race to cure cancer with thoroughly tested treatments from American scientists.
For decades, the war on cancer basically involved harming the patient in order to heal the patient. Doctors could use chemotherapy to poison cancer, they could use radiation to shrink it, or they could operate and try to cut the cancer cells out. All of these options inflicted harm on the patient, but also gave the patient a chance to survive the cancerous attack.
Breakthroughs over the years involved narrowing the beam of radiation, focusing the chemo, and honing the surgery through the use of robotics. But, because of the side effects, the process was still bad for the patient. In the future, however, doctors will concentrate on using the power of a patient’s own immune system to destroy cancer. There won’t be any damage to the patient, because it will be her own body that is ridding itself of malignant cells.
In fact, this dream treatment is already a reality in many places. Doctors are using chimeric antigen receptor T-cell therapy (CAR T-Cell therapy) to treat patients. This essentially teaches the patient’s body that the cancer cells are invaders. This type of treatment hasn’t been possible, because cancer cells are actually our own cells that have somehow malfunctioned. So a healthy immune system doesn’t usually target them until it is too late. By turning a person’s own immune system against cancer, patients can be treated without inflicting harm on their healthy cells.
Unfortunately, CAR T-Cell therapy isn’t as widely available as it could or should be, because it isn’t yet covered by Medicare in many places. That is a problem that the Trump Administration can, and must, address as quickly as possible. American lives are at stake in this case.
“The current doctor and hospital reimbursement process for CAR-T Medicare patients is broken,” retired Senator Tom Coburn warned earlier this year. “These inadequate reimbursements not only create access barriers for patients, but also a disparity between commercial and Medicare cancer patients, and between patients from urban and rural areas.”
Coburn was noted for fighting government waste, but he was also a medical doctor and a cancer patient. So there’s no better source for wisdom on this topic. Unfortunately, the new treatment arrived too late for the senator. He lost a long battle with cancer in March. Still, his warnings to the White House about expanding Medicare coverage can help save lives, and add to his already extensive legacy.
Finally, there’s a foreign policy component here.
Chinese scientists are racing in an attempt to develop CAR-T therapies. As is often the case, they are looking for shortcuts that could make testing easier even if they end up endangering patients. As the news service Axios reported last year, “While American and European companies take two to three weeks to engineer each patient’s CAR-T therapy, Chinese startup Gracell Biotechnology makes theirs overnight.” That pace could cause scientists to make mistakes that endanger patients.
Still, by cutting corners, the Chinese may be able to get a cheaper treatment to market. Of course, the best way to bring prices down is by making the treatment more widely available. As anyone who’s purchased a TV in recent years knows, prices for high-technology items come down quickly as the products are widely adapted.
The ball is in the Trump Administration’s court. It must be willing to invest in a solution that rewards those who provide this innovative cancer care. Until Medicare expands coverage, Americans remain at risk.
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