Wednesday, October 08, 2014

Rosy Outlooks, Stem Cell Therapy and Stunning Costs

It is nearly day three of the Stem Cell Meeting on the Mesa in San Diego, and the word that cannot be uttered has been heard: Expensive!

At least that’s what Bradley Fikes of the San Diego U-T has reported. Earlier this week, he was at the gathering of roughly 700 scientists, business people and investors.

Fikes wrote that “stem cell therapies appear poised to transform medicine.” But he also said that it is “clear that such innovations will be very expensive.”

Much has been written during the past year about the increasingly rosy outlook for stem cell research and possible therapies. Rarely is heard, however, a genuine discussion of the cost of such applications, including during meetings of the governing board of the $3 billion California stem cell agency. Nonetheless, affordability was part of Prop. 71, the measure that created the agency nearly 10 years ago.

Fikes did not offer any specific numbers for likely costs of the 131 stem cell therapies that are now being tested in California. He wrote,
“If the product is demonstrably superior to what’s currently available, cost won’t be an obstacle to reimbursement, said Nicholas Anderson, a medical technology analyst with Health Economics and Outcomes Research.”
Reimbursement, of course, is the industry euphemism for the pathway to a substantial profit.

Good reasons exist for avoiding public discussions of the cost of stem cell therapies, at least in the view of some in the field. One is that it is early in their development and not every financial aspect is fully understood. Another is that offering expensive estimates could trigger early controversy of the sort that has flared up nationally concerning more conventional treatments, such as those for cancer and hepatitis.

Nonetheless, considerable interest exists in the potential cost of stem cell therapy. One indicator is the amount of attention drawn by items on this Web site dealing with the likely expense of a stem cell treatment.

They consistently draw more attention than such matters as conflicts of interest at the stem cell agency and proposals for clinical trials.

A Google search this afternoon on the term “cost of stem cell therapies,” for example, produced 6 million results. No. 2 on the list was this item from 2013 on the California Stem Cell Report(CSCR):  “Cost of a Stem Cell Therapy? An Estimated $512,000

The item has received 8,756 page views, according to Google statistics.

The article was based on a report in the Wall Street Journal concerning a Japanese stem cell project.

Another example involves an item on a 2009 study on stem cell therapy costs commissioned by the stem cell agency. It received no public discussion by the agency's directors. The item on this blog about the study was seen 2,999 times. But the copy of the study itself has been viewed 15,989 times, nearly three times the attention of any of the other 164 documents posted by this Web site on the Scribd.com library site.

The California stem cell agency is on track to be involved in 10 clinical trials by the end of this year. As they progress, the potential costs of the partially publicly financed therapies could well become a matter for public debate. Particularly if the agency plans to ask California voters for more billions for stem cell research.   
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