Posted on 02/24/2020 7:01:04 PM PST by libh8er
India can help solve the accessibility problem of breakthrough cancer treatment CAR -T Cell therapy, according to American physician scientist Carl June.
CAR-T therapies have been effective against certain types of blood cancer. However, the treatment remained inaccessible to most patients due to its cost.
The CAR-T therapy costs about $1 million - $1.5 million, including administration and hospitalisation costs in US.
Novartis charges Kymriah - its CAR-T therapy about $475,000 for acute lymphoblastic leukemia (ALL).
ALL is type of childhood blood cancer. Novartis guarantees refund of money if the therapy doesn’t work after one month. It charges $373,000 for adult Non-Hodgkin lymphoma (NHL) – another form of blood cancer with no refund.
Gilead has priced Yescarta at $373,000 for NHL, with no refund.
Currently CAR-T cell therapies are not available in India. The prohibitive costs makes it beyond the means of most Indians. A few who can afford, anyways have the capacity to fly to US to get the treatment.
Making the CAR-T accessible
June in a recent interview to Moneycontrol on sidelines of BioAsia-2020 in Hyderabad said, the manufacturing complexity is a major reason for the therapy cost and despite such an expensive price tag he says Novartis doesn't make much profit.
"For normal drugs only about five or 10 percent of the selling cost is manufacturing. For the CAR-T cells one third of the selling price is manufacturing. So they don't make as much profit per patient, adding to that they give it on a guarantee. If it doesn't work, you get the money back. That's called pay for performance. No other time has that ever happened," June said.
June sees the manufacturing costs can probably come down by five to tenfold.
"Right now, the way they manufacture CAR-T cells is what we did in my lab in the 1990s. So it's 20 year old technology. And there was no industry on how to make, you know, robots and so on to do it automated. The most expensive part of CAR-T cells is human labour. It's you have to have trained people. So, if you can have it done automatic, then that would drop the cost dramatically," June said.
India role
June believes India can play a role in making CAR-T accessible and mainstream therapy.
"India is well positioned to (do) that because the country is so good with engineering. It's a natural thing to make better manufacturer," June said.
June also said India has good physicians who can do bone marrow transplants.
"…the people who start doing this will be bone marrow transplant. So they're the ones who take care of leukemia patients," June said.
But June said that the funding eco-system and government support in form of enabling rules and incentives will help the Indian companies to jump into CAR-T therapies.
"..(Kiran Mazumdar-Shaw) has started a company to do CAR-T cell therapy. There are several companies now in India who may look to solving this problem. And it needs to have a combination of some philanthropy, and then, the government has to want it to happen because it's a new industry and they can make rules and incentives," June said.
June points out that China has pumped $50 billion in CAR-T therapies and is home to around 300 clinical trials, while India has none.
Pioneering work
June led the pioneering work at University of Pennsylvania in US to develop the treatment where patient's own T-cell is drawn from the blood, isolated and genetically modified by adding chimeric antigen receptor (CAR).
The modified T-Cell weaponised with CAR, is grown and injected back into the patient. The modified CAR-T cells targets and kills cancer cells.
T-Cell – the important component of immune system acts like police chief in our body that detects intruders like viruses and bacteria, along with cancer cells.
The outcomes of CAR -T Cell therapy were astounding. Children suffering from advanced blood cancer (acute lymphoblastic leukemia or ALL), who were almost on verge of dying, saw their cancers gone.
Around 83 percent of the children with leukemia show complete remission within three months of receiving the treatment.
Swiss drug giant Novartis was quick to see the potential of the new therapy and teamed up with University of Pennsylvania in 2012. The partnership led to the development of tisagenlecleucel sold under brand name Kymriah by Novartis, became the first CAR-T therapy approved by USFDA to treat childhood leukemia and certain types of adult lymphoma in August 2017.
Two months later, the second CAR-T therapy called Yescarta was launched by US drug maker Gilead Sciences for several types of adult Non-Hodgkin lymphoma (NHL) – another form of blood cancer.
June said that CAR-T therapy is now explored as first line treatment, even before trying chemotherapy.
India....shudder! I would trust my worst enemy to their health care.
Don't look now, but many of the generic drugs major pharmacy plans supply are made in India.
I order a lot of my stuff from Canada and have found they actually arrive from India!!!
A lot of our medicines are made there now. Scares me too. I now have 18 Rxs and 6 OTCs that I take each day...
Yup. That is the case for me too.
India wants to make medical tourism a $9 billion industry by 2020
Oh yeah, the country that invented standardized parts, mass production, and the assembly line just cannot figure it out.
FOD India.
It's not a question of "figuring out". It's a question of cost. Same reason most consumer items come from China.
...and not from the country that invented mass production and the assembly line.
India is exporting lots of medical services — this is just an example. If the therapy costs a million dollars less in India than it does in the USA, then a lot of people could benefit.
You just have to watch out for side effects as the immune system is going apesh*t killing the cancer.
sposedly there’s a much much cheaper and more effective ‘cure’ on the way for many types of cancer- Some ‘accidental discovery’ that was in the news a few weeks or so ago-
“ It’s not a question of “figuring out”. It’s a question of cost. Same reason most consumer items come from China.”
China is nothing but a slave economy run by reptiles that our own “American” set of reptiles wishes to emulate.
Trees and rope is all we need herein the States.
Lol. That's vague enough--"many"--no name, no dates, no laboratories and "generic drugs pharmacy plans" which says nothing at all.
That reminds me of the old song, SIXTEEN TONS: "I own my soul to the company store."
EIGHTEEN prescriptions PLUS SIXTEEN over the counter?
You must spend your entire day just taking medications. Wow. I am sorry that your health is so poor.
Only if the trip to India doesn't kill you.
Google
A type of treatment in which a patient's T cells (a type of immune system cell) are changed in the laboratory so they will attack cancer cells. T cells are taken from a patient's blood. ...
CAR T-cell therapy is being studied in the treatment of some types of cancer. Also called chimeric antigen receptor T-cell therapy.
It all sounds VERY iffy, temporary and "maybe."
No. I know people who work on cancer and have seen clinical presentations by MSs on it. They take out certain immune cells, train them to look for the patient’s own cancer cells, then inject a truckload of them back into the patient.
Like giving a bloodhound an article of clothing to sniff...
You have FRMail...
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