this post was submitted on 02 Jan 2024
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[–] [email protected] 259 points 10 months ago (3 children)

The vaccine works by instructing the body to make up to 34 “neoantigens.” These are proteins found only on the cancer cells, and Moderna personalizes the vaccine for each recipient so that it carries instructions for the neoantigens on their cancer cells.

That’s pretty dope

[–] [email protected] 54 points 10 months ago (3 children)
[–] [email protected] 50 points 10 months ago (1 children)

I wonder if, even at this early stage of the therapy’s development, this would actually be more affordable than the alternative.

Melanoma patients are highly likely to have the cancer come back and or metastasize. Repeat treatments and hospitalizations are not cheap.

[–] [email protected] 35 points 10 months ago* (last edited 10 months ago) (2 children)

Which is why the Moderna vaccine will be priced at just 95% of the cost of the repeat treatments and hospitalization plus the value of the time saved and pain and suffering avoidance by the patient. Say, an extra half a million. I mean, what price would you put on avoiding seeing your parent or child subjected to round after round of chemotherapy?

[–] [email protected] 6 points 10 months ago (1 children)

So if this happens exactly as you describe, the net result will be a cancer treatment that is way more reliable and causes way less suffering than the existing treatments, and is slightly cheaper to boot?

That sounds awesome!

In reality they'll likely reduce the price more than that, because the balance between the supply/demand curve will likely give them even more profit if they drop it down farther. More people will be able to afford it so it'll create a bigger market. And then in a few years competitors will start coming out with their own mRNA cancer treatments and competition will start pushing it down even more.

[–] [email protected] 5 points 10 months ago (1 children)

No it will be more expensive. The pricing would be based on how much it currently costs, priced competitively (95% of, say, $500,000) and then they'd add $500,000 to account for the fact that you would recover more of your life and avoid suffering, so $950k total. Of course they may simply price is based on the value of your life. Say the average value of a human is $1.5M in a typical wrongful death suit; they might price it at $1.25M - a bargain!.

Before you laugh at my logic, I'll point out that Luxturna priced their retinal degeneration drug based on how much value courts placed on lost eyesight. They found that to be around the million-dollar range. The price of treatment was then set at $850,000, because that's clearly providing value over the monetary equivalent of loss of eyesight (Jeffrey Marrazzo, CEO, was quoted in an interview that this was the basis). Of course, there's an evilly fun MBA discussion to be had, as well, as your pricing could also be how much it's worth to a parent not to have to watch their children slowly and unavoidably go blind as they become teenagers. Other drugs are often based on the cost avoidance or value of human life of 100-150k per year, and I'm sure they will argue that a cure should account for the entire life amortization of such a cost. Maybe it will be $5M for someone in their 20s, but only $500k for someone in their 70s.

[–] [email protected] -1 points 10 months ago

If this is how they price these things, then why wasn't cancer treatment already $1.25M? Did they only just now realize how much they could squeeze out of people?

Luxturna's treatment is for a very rare form of blindness. Unfortunately treatments for rare diseases tend to be very expensive because of how R&D and the market works, there's much less opportunity to spread out the cost and mass production never happens. Melanoma is not a rare disease, unfortunately quite the opposite. Cancer in general even less so.

[–] [email protected] 11 points 10 months ago (2 children)

It'll be reasonably expensive, but sequencing and gene alteration is way cheaper than in needs to be.

If this can actually cure cancers, it may even be worth it.

The thing is, surely there's antibody against cancer antigens anyway, in ordinary cancer. A cancer cell expresses epitopes not on healthy cells.

Why is this better?

[–] [email protected] 6 points 10 months ago (1 children)

but sequencing and gene alteration is way cheaper than in[sic] needs to be.

...what? this sounds like you're advocating for price increases.

[–] [email protected] 13 points 10 months ago

Oops, new to Lemmy. But not new to typing, so no excuse.

I meant than "it used to be".

I blame autocorrect.

[–] [email protected] 1 points 10 months ago

I think "reasonable" is doing a lot of heavy lifting here. Whatever price they charge it will be to maximize to Moderna's profits - i.e. they'll price it slightly lower than what insurers / national health systems would be stung for what 44% of melanoma patients needing a second round of expensive chemo would cost them but not so high that no one will cover the treatment. So I guess the price is "reasonable", in that it'll be cheaper than the alternative but it's not like Moderna will be charitable or fair about it.

It's still an amazing breakthrough though.

[–] [email protected] 8 points 10 months ago (1 children)

Also sounds very hard to do a proper controlled trial on. Every treatment produces a different protein, so there's no consistent factor to test except for the delivery mechanism.

[–] [email protected] 7 points 10 months ago (1 children)

There's still ways but not trivial. You have to do multifactor analysis, but it's gonna have a ton of noise unless you have a large sample of different people with recurring "neoantigens". It's similar to how drug side effects are tracked for people who take multiple medicines, you compare against populations which share different combinations of the same factors.

[–] [email protected] 1 points 10 months ago* (last edited 10 months ago)

Multifactor analysis still requires an underlying commonality. People taking multiple drugs are all still taking the drug being trialed. You're removing the confounding factors. If every treatment is a unique cancer protein there is no common factor. The treatment is the confounding factor.

To put it another way. A safety trial has to prove that any protein administered is safe.

Edit: just realised you're probably talking about efficacy trials, whereas I'm more concerned with safety.