A group of academics have channeled their inner Bernie Sanders and written a wonderfully naïve op-ed about how to lower drug prices: Destroy the industry that made America the world leader in biotechnology.

It's simple. Let government control drug prices and then corporations will just do what they always do, but it will be a lot cheaper. It is so simplistic it could have been written by Paul Krugman in the New York Times. It is also in defiance of how science, creativity and medical advancement works, and would lead to a mass exodus of science jobs from America.

Writing about the piece in Mayo Clinic Proceedings, lead author Ayalew Tefferi, M.D., a hematologist at Mayo Clinic, says, "The average gross household income in the U.S. is about $52,000 per year. For an insured patient with cancer who needs a drug that costs $120,000 per year, the out-of-pocket expenses could be as much as $25,000 to $30,000 - more than half their average household income."

He and colleagues cite a 2015 study by D.H. Howard and colleagues in the Journal of Economic Perspectives, which found that cancer drug prices have risen by an average of $8,500 per year over the past 15 years. What has risen markedly in that time? Cancer survival rates. 

They claim that by controlling the market, the free market will work better. If you are a California resident enjoying paying 50 percent higher utility rates compared to the rest of the country, you see how in the real world more government control does not make the free market more efficient. If you can do math, it is better to be skeptical.

Here are their recommendations, and then evidence-based insight:

Academics: Create a post-U.S. Food and Drug Administration drug approval review mechanism to propose a fair price for new treatments that is based on the value to patients and heath care

Reality: Drug prices have gone up because government has created a Byzantine approval process, it now takes a dozen years and $2 billion to get a successful drug approved. This notion says companies should do all that work, spend the money, and then get told what to charge.

Academics: Allow Medicare to negotiate drug prices

Reality: The government will dictate prices, and industry will scale back to match it. If you are trying to get a doctor's appointment from the Veteran's Administration or under the Affordable Care Act, you already know what happens when government controls cost. It instead controls supply. Innovation costs money. If government controlled the cost of cell phones, we would still be using those giant brick things from the 1980s.

Academics: Allow importation of cancer drugs across borders for personal use (For example, prices in Canada are about half of prices in the U.S.)

Reality: Let Canadians subsidize drug costs for American consumers - or do what Canadians do and create a price floor for generic drugs, which the U.S. does not have. In reality, many poor person have a high-definition television and a cell phone because rich people pay more for faster access to technology. That is the long tail of economics. Even Paul Krugman understands that. Some African companies pay a dollar for a drug, and that is because companies can afford to do so after uptake in rich countries. In proposing this, these academics must be secretly neo-conservatives who believe poor people should be doomed to never affording drugs because they are not wealthy elites born in America.


Want to have no drug development at all, but make sure people die cheap? Ask academics how to fix science.

Academics: Pass legislation to prevent drug companies preventing a drug becoming generic 

Reality: There are two issues here. One is that generic drugs have not actually helped much. As soon as a generic drug is truly cheap, the generic manufacturer abandons it. This also does nothing to solve the problem of the cost of discovery, it is just vague populism.

Academics: Reform the patent system to make it more difficult to prolong product exclusivity unnecessarily

Reality: "Unnecessarily"? Most academics have never actually created a product so this fuzzy, pointless language would be exploited by the large companies they seek to penalize, while killing small companies, which are already being damaged by the onerous approval process these academics want to make even longer, more expensive and less rewarding.

Academics: Encourage organizations that represent cancer specialists and patients (e.g., American Society of Clinical Oncology, American Society of Hematology, American Association for Cancer Research, American Cancer Society, National Comprehensive Cancer Network to consider the overall value of drugs and treatments in formulating treatment guidelines

Reality: This is another example of the concern people have about "death panels" - treatment guidelines for the rich and the poor will be different. Right now, American health care is expensive because every life is important and doctors are steeped in that mentality. Increasing such a "teach to the protocol" environment, and creating more centralized control over medical decision-making, will mean the most disenfranchised people will be impacted.

20 years ago, people said they wanted doctors to make decisions, and not the government. Now the American Cancer Society is going to pick winners and losers in the marketplace and among the public? Not a good idea for anyone.

*****

It's laudable that a team of academics have gotten together to draft a plan that other academics will cheer about (corporations evil, academics goooood) - but it is instead a reminder that it is always easy to spend someone else's money. To people who understand economics and drug development, these recommendations are equivalent to a homeopath telling doctors 'you don't know until you try it' about curing cancer.

Citation: Tefferi, Ayalew et al., In Support of a Patient-Driven Initiative and Petition to Lower the High Price of Cancer Drugs, Mayo Clinic Proceedings July 23, 2015 DOI: http://dx.doi.org/10.1016/j.mayocp.2015.06.001

Co-authors include:

Vincent Rajkumar, M.D., Mayo Clinic, Rochester
Morie Gertz, M.D., Mayo Clinic, Rochester
Robert Kyle, M.D., Mayo Clinic, Rochester
Hagop Kantarjian, M.D., University of Texas MD Anderson Cancer Center, Houston
James Allison, University of Texas MD Anderson Cancer Center, Houston
Robert Bast Jr., University of Texas MD Anderson Cancer Center, Houston
Jorge Cortes, M.D., University of Texas MD Anderson Cancer Center, Houston
Isaiah Fidler, D.V.M., Ph.D., University of Texas MD Anderson Cancer Center, Houston
Emil Freireich, M.D., University of Texas MD Anderson Cancer Center, Houston
Jordan Gutterman, University of Texas MD Anderson Cancer Center, Houston
Waun Ki Hong, University of Texas MD Anderson Cancer Center, Houston
Gabriel Hortobagyi, M.D., University of Texas MD Anderson Cancer Center, Houston
John Mendelsohn, M.D., University of Texas MD Anderson Cancer Center, Houston
Louise Strong, M.D., University of Texas MD Anderson Cancer Center, Houston
Naoto Ueno, M.D., Ph.D., University of Texas MD Anderson Cancer Center, Houston
Charles LeMaistre, M.D., University of Texas MD Anderson Cancer Center, Houston
Lawrence Baker, D.O., University of Michigan, Ann Arbor, Michigan
Theodore Lawrence, M.D., Ph.D., University of Michigan, Ann Arbor
Jan Abkowitz, M.D., University of Washington Medical School, Seattle
Joachim Deeg, M.D., University of Washington Medical School, Seattle
Elihu Estey, M.D., University of Washington Medical School, Seattle
Gary Lyman, M.D., M.P.H., University of Washington Medical School, Seattle
John Adamson, M.D., University of California, San Diego School of Medicine, La Jolla, California
Ranjana Hira Advani, M.D., Stanford University School of Medicine, Stanford, California
Steven Coutre, Stanford University School of Medicine, Stanford
Peter Greenberg, M.D., Stanford University School of Medicine, Stanford
Michael Link, M.D., Stanford University School of Medicine, Stanford
Saul Rosenberg, Stanford University School of Medicine, Stanford
Karen Antman, M.D., Boston University School of Medicine, Boston
John Bennett, M.D., University of Rochester Medical Center, Rochester, New York
Edward Benz Jr., M.D., Dana-Farber Cancer Institute and Harvard Medical School, Boston
George Peter Canellos, M.D., Dana-Farber Cancer Institute and Harvard Medical School, Boston
George Daley, M.D., Ph.D., Dana-Farber Cancer Institute and Harvard Medical School, Boston
Daniel DeAngelo, Dana-Farber Cancer Institute and Harvard Medical School, Boston
Charles Fuchs, M.D., M.P.H., Dana-Farber Cancer Institute and Harvard Medical School, Boston
Robert Handin, M.D., Dana-Farber Cancer Institute and Harvard Medical School, Boston
Philip Kantoff, M.D., Dana-Farber Cancer Institute and Harvard Medical School, Boston
David Steensma, M.D., Dana-Farber Cancer Institute and Harvard Medical School, Boston
Richard Stone, Dana-Farber Cancer Institute and Harvard Medical School, Boston
Eric Winer, M.D., Dana-Farber Cancer Institute and Harvard Medical School, Boston
Nancy Berliner, M.D., Brigham and Women's Hospital, Boston
Robert Handin, M.D., Brigham and Women's Hospital, Boston
Joseph Bertino, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey
Ravi Bhatia, M.D., University of Alabama at Birmingham, Birmingham, Alabama
Smita Bhatia, M.D., University of Alabama at Birmingham, Birmingham
Harry Erba, M.D., Ph.D., University of Alabama at Birmingham, Birmingham
Deepa Bhojwani, M.D., Children's Hospital Los Angeles, Los Angeles
Charles Blanke, M.D., Oregon Health&Science University, Portland, Oregon
Clara Bloomfield, M.D., The Ohio State University Comprehensive Cancer Center, Columbus, Ohio
John Byrd, M.D., The Ohio State University Comprehensive Cancer Center, Columbus
Raphael Pollock, M.D., Ph.D., The Ohio State University Comprehensive Cancer Center, Columbus
Linda Bosserman, M.D.
Stephen Forman, M.D., City of Hope Medical Foundation, Duarte, California
Hal Broxmeyer, Ph.D., Indiana University School of Medicine, Indianapolis
Lawrence Einhorn, M.D., Indiana University School of Medicine, Indianapolis
Fernando Cabanillas, M.D., Auxilio Cancer Center, Hato Rey, Puerto Rico
Bruce Chabner, M.D., Massachusetts General Hospital, Boston
Gerardo Colon-Otero, M.D., Massachusetts General Hospital, Boston
Asher Chanan-Khan, M.D., Mayo Clinic, Jacksonville, Florida
James Foran, Mayo Clinic, Jacksonville, Florida
Bruce Cheson, M.D., Georgetown Lombardi Comprehensive Cancer Center, Washington, D.C.
Bayard Clarkson, M.D., Memorial Sloan Kettering Cancer Center, New York City
Sergio Giralt, Memorial Sloan Kettering Cancer Center, New York City
Clifford Hudis, M.D., Memorial Sloan Kettering Cancer Center, New York City
Ross Levine, M.D., Memorial Sloan Kettering Cancer Center, New York City
Martin Tallman, Memorial Sloan Kettering Cancer Center, New York City
Anas Younes, M.D., Memorial Sloan Kettering Cancer Center, New York City
Andrew D. Zelenetz, Memorial Sloan Kettering Cancer Center, New York City
Susan L. Cohn, M.D., University of Chicago, Chicago
Harvey Golomb, M.D., University of Chicago, Chicago
Samuel Hellman, M.D., University of Chicago, Chicago
Richard A. Larson, M.D., University of Chicago, Chicago
Wendy Stock, M.D., University of Chicago, Chicago
Massimo Cristofanilli, M.D., Sidney Kimmel Cancer Center at Thomas Jefferson University, Philadelphia
Walter Curran Jr., M.D., Winship Cancer Institute of Emory University, Atlanta
Fadlo Khuri, M.D., Winship Cancer Institute of Emory University, Atlanta
Sagar Lonial, M.D., Winship Cancer Institute of Emory University, Atlanta
George Daley, M.D., Ph.D., Boston Children's Hospital, Boston
Joachim Deeg, M.D., Fred Hutchinson Cancer Research Center, Seattle
Gary Lyman, M.D., M.P.H., Fred Hutchinson Cancer Research Center, Seattle
Oliver Press, M.D., Ph.D., Fred Hutchinson Cancer Research Center, Seattle
Jerald Radich, M.D., Fred Hutchinson Cancer Research Center, Seattle
Brenda Sandmaier, Fred Hutchinson Cancer Research Center, Seattle
Rainer Stone, Fred Hutchinson Cancer Research Center, Seattle
Francisco Esteva, M.D., Ph.D., New York University Langone Medical Center, New York City
James George, M.D., University of Oklahoma Health Sciences Center, Oklahoma City
Paulo Marcelo Hoff, M.D., Universidade de Sao Paulo, Sao Paulo
Ronald Hoffman, Icahn School of Medicine at Mount Sinai, New York City
Mary Horowitz, M.D., M.S., Medical College of Wisconsin, Milwaukee
Jean Pierre Issa, M.D., Temple University, Philadelphia
Bruce Evan Johnson, M.D., Lowe Center for Thoracic Oncology, Boston
Kenneth Kaushansky, M.D., Stony Brook University, Stony Brook, New York
David Khayat, M.D., Ph.D., Pitié-Salpêtrière Hospital, Paris
Thomas Kipps, M.D., Ph.D.
Scott Lippman, M.D., University of California, San Diego Moores Cancer Center, La Jolla
Margaret Kripke, Cancer Prevention and Research Institute of Texas, Austin, Texas
Maurie Markman, M.D., Cancer Treatment Centers of America, Eastern Regional Medical Center, Philadelphia
Neal Neropol, M.D., University Hospitals Case Medical Center and Case Western Reserve University, Cleveland
Yoav Messinger, M.D., Children's Hospitals and Clinics of Minnesota
Therese Mulvey, M.D., Southcoast Centers for Cancer Care, Fairhaven, Massachusetts
Susan O'Brien, M.D.
Richard Van Etten, M.D., Ph.D., University of California, Irvine, California
Roman Perez-Soler, Albert Einstein College of Medicine, New York City
Josef Prchal, M.D., University of Utah, Salt Lake City
Kanti Rai, North Shore-LIJ Cancer Institute, New York
Jacob Rowe, Northwestern University Feinberg School of Medicine, Chicago
Hope Rugo, University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, San Francisco
Carolyn Runowicz, M.D., Florida International University Herbert Wertheim College of Medicine, Miami
Alan Saven, M.D., Scripps Clinic Medical Group, La Jolla
Richard Silver, M.D., Scripps Clinic Medical Group, La Jolla
Andrew Schafer, M.D., Weill Cornell Medical College, New York City
Charles Schiffer, Barbara Ann Karmanos Cancer Institute, Detroit
Mikkael Sekeres, M.D., M.S., Cleveland Clinic, Cleveland
Lillian Siu, M.D., Princess Margaret Cancer Centre, University Health Network, Toronto
Marc Stewart, M.D., Seattle Cancer Care Alliance, Seattle
Michael Thompson, M.D., Ph.D., Aurora Research Institute, Aurora Health Care, Milwaukee
Julie Vose, M.D., M.B.A., University of Nebraska Medical Center, Omaha, Nebraska
Peter Wiernik, M.D., Cancer Research Foundation, New York City