[nostromo]

Perhaps they’re behaving entirely rationally. Infectious diseases do not kill that many people compared to cancer in America.

We may have a bad “flu” year this year, with a spike of elderly deaths, but we have a bad cancer year every year.

[JamesBarney]

But we don't really develop "cancer" drugs. We develop a drug that treats certain type of pancreatic cancer that give the individuals another 3-6 months to live. But curing an infectious disease can give someone another 40 years.

[refurb]

There are several cancer (lymphomas) that were literal death sentences a decade or two ago, but how have a very high cure rate.

It's not fair to say we don't develop cancer drugs because some, very difficult to treat cancers, haven't seen as much progress as others.

[dehrmann]

Testicular cancer is now very treatable, but before Cisplatin, the prognosis was pretty grim. I guess to grandparent's comment, we absolutely do develop chemotherapy drugs, and many don't just buy you six months, they're life-saving.

[refurb]

I unfortunately can't find it, but there was an interesting chart that showed overall survival in metastatic colorectal cancer.

It covered the last 30 years. Each new therapy improved survival by only 6-12 months, but each new drug was more effective than the last. Over those 30 years, the median survival went from 6 months to over 5 years.

People shouldn't discount incremental improvements because that's often how medicine progresses.

[DrScump]

Cell type is much more relevant to curability than location.

[drocer88]

This recent drug does better than 3-6 months: Nivolumab . One-Third of Patients With Advanced Melanoma Survive at Least 5 Years After Nivolumab Treatment. (https://www.ascopost.com/issues/may-10-2016/one-third-of-pat...

Here's another recent success : https://hcp.lutathera.com/ --- https://www.nejm.org/doi/full/10.1056/NEJMoa1607427 At the data-cutoff date for the primary analysis, the estimated rate of progression-free survival at month 20 was 65.2% (95% confidence interval [CI], 50.0 to 76.8) in the 177Lu-Dotatate group and 10.8% (95% CI, 3.5 to 23.0) in the control group.

Lutathera delivers a radioactive molecule to the tumor.

[m0zg]

$150K+/yr. OOF. On the positive side, 20 years from now these drugs will be dollar a bucket as generics. Thank god for capitalism.

[_lqaf]

No, it won't. Look at inulin prices. Or pharma-bro's Daraprim.

That's what capitalism does to generics.

[m0zg]

Not really. Regarding insulin, that's what _the lack of capitalism_ does to generics. You can't import insulin into the US, and that's why it's so expensive here.

Daraprim wasn't generic until literally 5 days ago: https://www.biospace.com/article/fda-approves-first-generic-...

[briandear]

How much experience do you have in oncology? There are millions of breast cancer survivors that might disagree with you. There is also the false assumption that we haven’t made much progress in infectious diseases when, in fact, we have. Tamiflu was launched in 1999. AIDS drugs are light years ahead of where they were 25 years ago. We have effective vaccines for some of history’s worst killer diseases. Gilead has been working on remdesivir since 2016 for Coronaviruses. Hepatitis C is now curable (also thanks to Gilead.)

There is a lot of significant work happening in infectious diseases. However, curing cancer is the holy grail and a pursuit of that is on the same level as pursuing manned space flight. Flying people into space seemed frivolous at the time as well. After all, think of all of the hungry kids would could feed if we redirected Apollo money! However, space flight gave society countless advances that we didn’t foresee at the time. Perhaps we should argue that studying quantum physics is a waste of resources. Or studying astronomy. Or any number of fields where societally-useful breakthroughs are few and far between.

It’s ridiculous to imply that developing cancer drugs should be ditched in favor of developing more infectious disease drugs. We can walk and chew gum at the same time: this isn’t guns or butter.

If we want to apply pure rationality to drugs: let’s stop cancer drug expenditures so we can save more people from malaria, then we could apply that logic to social programs as well: why bother helping the mentally disabled when instead we could direct those funds towards something that provides more economic value to society? A kid with cerebral palsy isn’t going to contribute as much to society as a healthy kid — so why waste resources on that research? Of course it isn’t a waste when it’s your kid. Following that line of reasoning and we ultimately end up with eugenics and society would become a very nasty place indeed.

[est31]

Cancer is an extremely complex disease and we are making real progress on it. Only because we don't discover a powerful medication like antibiotics that eliminates multiple types of the same disease doesn't mean that we aren't making progress.

[Broken_Hippo]

We do develop "cancer" drugs to a point. That HPV vaccine is preventing an entire group of cancers!

But cancer itself is... complicated. There are many different types with many different causes that are complicated by many different things. Breast cancer is not the same as skin cancer, and neither of these are lung cancer.

But we do, to an extent, know how to treat things to a point. Sometimes, our best efforts have only resulted in giving folks 3-6 months.

And we do cure or prevent some infectious disease. The plague and leprosy, for example, is curable. We have taken leaps and bounds with HIV/Aids - while we can't really cure it, we can give drugs to folks to stop it from being so infectious. But like cancer, "infectious disease" comes in many forms, some being vastly more complicated to "cure" than others. This is why some things, like the common cold and common influenza do not have cures. These are hard problems. And for lack of better words, we've simply not "unlocked" the secret in ways that would be good year after year.

[empath75]

This bad flu is going to kill tens of millions of people and wipe out health systems around the world and wreck the world economy. I wish people would stop downplaying it.

[Aunche]

If it is really going to kill tens of millions of people, you can bet that pharmaceutical companies are already working on cures.

[StanislavPetrov]

Perhaps what's "rational" in a purely economic sense isn't whats best for the nation or for society. In an economic sense, you could make an argument that slavery is "rational" as far as profits for slaveholders are concerned, but we don't allow slavery because its wrong and immoral despite the potential economic benefits to certain vested interests. Similarly, perhaps its time that we as a society reevaluated our reliance on health care delivery systems that base their agenda on outcomes that are economically profitable for them, rather than what is desirable for our society as a whole.

[roenxi]

Slavery is economically irrational. The risk of losing a William Deming or a Tim Cook because they were enslaved is far more damaging than the benefits of guaranteed cheap manual labour. We have an economy where a 1 in 100 worker is much more productive than the other 99 if they are allowed to make their own decisions about where they contribute. Funnily enough; the people with moral objections to slavery gained ascendancy at roughly the same time it became economically irrational. And started winning wars against slavery-tolerant societies because slave-based economies couldn't possibly compete with technology and industrial processes in the hands of free people.

[dodobirdlord]

Slavery, really? Besides, totally beside the point. The argument for rationality isn't that if we exclude the people who experience downside, maybe it's a net positive (always true by tautology), but rather that maybe even counting the people who experience the downsides it's still rational. The novel coronavirus is likely to end the lives of a lot of elderly people, but the majority of elderly people are going to have their lives ended by cancer or heart disease. Perhaps, even with the threat of pathogens like the novel coronavirus lurking to strike, it still makes sense to put most of our resources toward researching cancer and heart disease.

[geofft]

Yes, slavery, really. Rational actors today engage in slavery. https://venturebeat.com/2020/03/02/apple-foxconn-and-81-othe...

And you can construct a "rational" argument for it: the slaves are living under an oppressive government anyway and apparently nobody is going to intervene, so if they're stuck in internment camps, may as well give them something to do with their time. Sure, they don't have freedom, but they weren't going to have it anyway, so it's still rational. Right?

In seriousness - if you don't take into account the economic reliance on slavery that jurisdictions with legal slavery (e.g., the US South in the 1800s) had, and you claim it's solely that irrational slaveholders saw certain people as less than human in the abstract, you've missed a good part of the explanation and risk inaccurately understanding how to prevent it from happening again. People had a strong economic incentive to come up with justifications for their objectively immoral actions.