The New York Times recently profiled pay-for-performance and risk-sharing pricing arrangements for high-cost drugs, including cancer drugs.

For example, Johnson & Johnson has proposed that the NHS in Britain pay for the cancer drug Velcade, but only for people who benefit as evidenced by tumor shrinkage. Velcade can cost $48,000 per patient. According to industry analysts quoted in the article, such a pricing scheme would probably only work in countries where there are single-payer health systems.

According to Dr. Lee N. Newcomer, senior vice-president for oncology at UnitedHealthcare, such risk-sharing arrangments would be harder to manage in the U.S. Newcomer says, "There's no way we could ask for it and have any leverage." He explains that state regulations and market forces make it impossible for an insurer to refuse to pay for a drug that has been approved by the FDA.

Other drugs cited in the article as potential targets for risk sharing between the manufacturers are Avonex for multiple sclerosis and even statins.

A bundle of scientific reports indicate more than 200 chemicals, found in the air and in consumer products, cause breast cancer in animal tests.

Researchers report in an American Cancer Society publication that reducing exposure to such compounds could prevent many women from developing the disease.

Family history and genetic make-up are responsible for only a small percentage of breast cancer cases. Environmental and lifestyle factors, such as diet, are most likely involved in the majority of cases, say experts.

ImClone Systems Inc.'s drug Erbitux has failed to help pancreatic cancer patients live longer. It's also failed to grow ImClone's market -- not surprising since it's the company's only drug.

Imclone, partnering with Bristol-Myers Squibb Co., wanted to see Erbitux -- already cleared for use with colon, head, and neck cancers -- extend the lives of patients with cancer marked by a spread to the pancreas.

No one is giving up just yet, and Imclone plans additional tests on Erbitux's use in pancreatic cancer. A study using a combination of Erbitux and Avastin and chemotherapy is up next.

"There are reasons to think Erbitux works in pancreatic cancer, but the current results are not as dramatic as we hoped," said Alex Denner, lead for an executive committee that manages ImClone. "We remain committed to evaluating Erbitux in pancreatic cancer."

If approved, Erbitux will compete with Tarceva, sold by Roche Holding AG, Genentech Inc., and OSI Pharmaceuticals Inc. as a treatment for pancreatic and lung cancers.

About 37,170 new cases of pancreatic cancer are expected to occur in 2007 in the United States. And 33,370 people will die from the disease, according to the American Cancer Society. Pancreatic cancer is one of the most aggressive cancers, and there is no screening option that works at catching the disease in its early stages.

Only about 5 percent of patients with pancreatic cancer are still alive five years after being diagnosed.

More than 47 percent of people view their pets as family members, according to a 2002 American Veterinary Medical Association survey. It makes sense then that people are routinely treating their pets for ailments that might strike a family member -- like arthritis, heart disease, diabetes, allergies, dementia, obesity, and yes, cancer.

New studies show that Americans are stuffing their pets with more drugs than ever before. They are medicating their dogs, cats, and sometimes other pets as much as they medicate themselves -- and they are doing it with many of the same human drugs they use for themselves, like steroids for inflammation, antibiotics for infection, anti-depressants for anxiety, and even new slendering drugs for obesity.

It's a big market -- pharmaceuticals for pets -- and for those who love their pets so much they can't let go, going to extremes is worth every penny.

Think about this:

• For dogs and cats alone, Americans spent $2.9 billion on pet drugs in 2005. While this is equal to only one percent of human drug sales, the market has grown by half since 2000.

• The U.S. Food and Drug Administration (FDA) has approved more than 40 new pet drugs in the past five years.

• A single three-month course of pet chemotherapy can cost $3,000 -- and chemotherapy doesn't typically extend the life of an animal as much as it soothes symptoms of the disease.

• Health insurance for pets was nearly invisible in 2002 but has gained popularity over the past few years. Premiums can cost $30 per month, and the total market is expected to climb to $500 million in the next five years.

• Some human drugs leave pets with unexpected, sometimes deadly, side effects. The drug Rimadyl, made by Pfizer and used as a treatment for dogs with arthritis, has been shown to cause kidney and liver damage in some animals. More than 3,000 pet deaths have been attributed to this drug.

• Some question the priorities of a society that allows for medically treating pets like they are humans. Dianne Dunning, an ethicist at N.C. State's vet school is concerned that millions of animals are lost, unwanted, and euthanized while millions are spent on pet medicines. David Rothman, an expert in medicine's role in society from Columbia University, says, "If you can't get malaria drugs in some Third World countries, what are we doing with chemotherapy for cats?"

• Others don't flinch at the expense it requires to keep their pets alive. One man, whose dog was expected to die of lymphoma within weeks, still enjoys the company of his pet some two years later. Chemotherapy saved the dog's life and when asked if he thinks the drugs are too expensive, this man says NO -- because his dog is still here.
  

Cancer drug Nexavar has made its point. It can help people with liver cancer survive longer.

Bayer Pharmaceuticals and Onyx Pharmaceuticals announced Monday that advanced stage clinical trials for this drug will end early. And now patients in the placebo arm of the study can begin treatment with the actual drug.

It's been a long road for researchers who have been searching for a liver cancer treatment that can target tumors with minimal side effects while extending life for months or even years.

It is estimated that 16,780 people in the United States will die from liver cancer in 2007 -- and it seems Nexavar, a drug initially predicted to fail when used for liver cancer -- may help save some of these lives.

Bayer and Onyx are planning to pursue FDA approval for this drug that has already been approved for kidney cancer.

During clinical studies, the Virtual Cancer Patient Engine (VCP) was found to be 70 percent accurate in predicting individualized patient response to chemotherapy drugs. The significance of the ability of this new technology to make accurate predictions in cancer treatments that will work before treatment begins is a 40 to 45 percent better accuracy rate than is currently predicted by oncologists. VCP analyzes how chemotherapy drugs will affect the growth of the cancer, how the chemotherapy drugs will behave in the body and how the cancer cells will respond to the chemotherapy drugs using mathematical modeling and computerized simulation between biological, pathological and pharmacological processes of drug-patient interactions.

According to researcher Dr. Abhik Mukherjee, "Every cancer is slightly different and every patient will respond to treatment differently. We wanted to find a way to predict how patients would respond to a particular drug in order to limit their side effects and give them the best chance of beating their disease."

Rather than throwing everything at the wall to see what sticks, as Katie Couric described current cancer treatments, this technology has the potential for creating individualized treatments specific to the patient and their cancer in determining what will work ahead of time without putting the patient through unnecessary treatments that will not work. To learn more, visit Optimata.

New approaches are needed to treat advanced melanoma. Melanoma is the type of skin cancer that can be deadly if it travels to distant parts of the body. Survival is usually only 6-9 months for patients with metastatic melanoma.

Synta Pharmaceuticals says that an agent called STA-4783 when added to Taxol can double the progression free survival compared with using Taxol alone. STA-4783 can enhance the cancer killing effects of the immune system.

Researchers from 21 clinical sites in the US recently conducted a clinical trial to evaluate the addition of STA-4783 to Taxol in patients with Stage IV melanoma. Anticancer responses occurred in 15 percent of patients treated with STA-4783 and Taxol and only 4 percent had anticancer response from the Taxol alone.

Patients should ask their physicians about the clinical trials that are available for STA-4783 plus Taxol.

On May 31, 2006 I wrote a post about oral cancer screening.  I was contacted by a public relations person from Zila Pharmaceuticals by the name of Bill Sklar who shared a lot of facts with me on the subject. He also told me of a new test that is simple and easy to detect oral cancer and it is now on the market. The screening test is called ViziLite and it is FDA approved. I will be taking the test to see how simple and easy it is and will give a report about my experience on this blog. I would like to share some of the facts that were given to me about oral cancer.

• One American dies every hour of oral cancer.
• 25 percent of cases affect people with no known risk factors.
• 75 percent of cases are related to tobacco or alcohol use.
• Oral cancer is increasing among women.
• The 5-year survival rate is 57 percent, and the 10-year rate is under 50 percent.
• Oral Cancer is horribly disfiguring and painful, unless it's detected early.
• Oral cancer can be caused by HPV - transmitted through oral sex.
• Sigmund Freud, Babe Ruth, John Gotti and President Grover Cleveland had oral cancer.
• Cigar smoking increased 250 percent from 1993 to 1998, and heavy cigar use is particularly associated with oral cancer development.
• Marijuana appears to cause oral cancer, particularly in younger patients.

Arnold Rosenheck, DMD, Associate Dean, UMDNJ-New Jersey Dental School says the annual cost for treating oral cancer in the U.S. is $2 billion, and when indirect costs are added in (rehab, lost wages, etc.), the figure balloons to $8 billion. The American Cancer Society estimates about 30,990 new cases (20,180 in men and 10,810 in women) of oral cavity and oropharyngeal cancer will be diagnosed in the U.S. in 2006. Roughly 7,320 people (4,910 men and 2,410 women) died of these cancers in 2005.