Gleevec – The Wonder Drug
Imatinib is a drug used to treat certain types of cancer. It is currently marketed by Novartis as Gleevec (USA) or Glivec (Europe/Australia)
This drug presents an interesting dilemma when talking about health care costs in America. In the 1960’s it was discovered that patients with chronic myelogenous (or myeloid) leukemia (CML) had a common unusual chromosome. This was found to be due to the transposition of two chromosomes, that when joined creates a new gene (Philidelphia Gene PH+) that acts as the factory pumping out a new enzyme; which results in the production of defective and harmful white blood cells. Interested parties began working to find compounds that would inhibit these enzymes. In 1994, Novartis successfully patented compounds that showed the potential to do so.
The story may have ended here if it wasn’t for Dr. Brian J. Drucker a research physician in hematology working at the Oregon Health Sciences Univeristy in Portland. Novartis initially had no interest in continuing research into the patented compounds. With only 5,000 new cases a year of CML, development of these compounds did not seem a worthwhile investment. Dr. Drucker, became interested in these compounds as a possible treatment for people afflicted with CML. In working with Novartis, Dr. Drucker was able to obtain a few of their more promising enzyme inhibitors.
Through his research he was able to discover the Gleevec was extremely effective at inhibiting the growth of the harmful white blood cells. It also had the side benefit of having very little side effects. For cancer treatment, this was truly a breakthrough. Novartis still resisted investing in the drug, as again, the target market was not large enough to make the investment seem viable. Fortunately persistence won out at the end of the day. Dr. Drucker managed to convince Novartis to support some small scale clinical trials. In 1999, Dr Drucker presented his dramatic findings to the world, and it was greeted with widespread interest. At this point, Novartis became a very interested party. The drug was run through large scale clinical trials, and was approved by the FDA.
Today, with Gleevec, the average five-year survival rate for patients with CML is 90%. It has also become part of the preferred treatment for people like myself who are afflicted PH+ Acute Lymphoblastic Leukemia (ALL). It has become an essential component in the fight to keep my Leukemia in remission while awaiting a bone marrow transplant.
So far the story seems fit for TV. An outoging doctor, who rolled up his sleeves and worked part-time at a cancer clinic. Who was then inspired by his patients to work and push harder on their behalf. He fought against the disinterest of the large corporation, and found the wonder drug that would revolutionize the treatment of Leukemia.
So now we arrive at the happy ending, right?
For some yes. For those with health insurance, Gleevec continues to work miracles in the everyday lives of cancer survivors. Its high effectiveness and small list of side effects are a truley magnificent discovery that have added many years to cancer survivors lives.
But there is always the flip side of the coin.
The cost.
A month supply of Gleevec costs over $3,000-4,000 depending on your dosage.
So where does that leave the uninsured and underinsured. Its not hard to guess. You can easily find stories of people who cannot afford the medication. Stories of people who rely on the kindness of community organizations to defray the costs, and those who manage to qualify for free or reduced handouts from Novartis. In-line with those stories, you will find sympathetic individuals from countries with socialized medicine that pay for the life saving medication, and suggestions to try to import the drugs from countries like India that produce generic forms of the drug. Though, that is a story unto itself.
Throughout the day, when I talk to friends and family. I try to share what I have learned, in an effort to educate as many people as possible. Each time I tell my story, I am reminded of how lucky I am to work for a great company, and knock on wood, have good health coverage. But my story could easily have been different. If presented with the realities of paying over $3,000 a month for a life-giving prescription, while fighting cancer, and trying to provide for a wife and daughter… I really don’t know if I would be doing as well in my fight as I am today.
Its not death that I am afraid of. What scares the hell out of me is not being there for my wife; not being there for my precious daughter. Would it be in their best interest to sustain my life at the expense of possible life-long financial ruin? Would that be selfish of me?
I can’t for the life of me understand why in the hell this a question many American’s are forced to ask themselves.
