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@tompowles1 - I appreciate your enthusiasm for this. But we don’t know that this strategy is more effective than simply 2nd line, due to >50% pts in the control arm not getting 2nd line IO. The duration of tx of avelumab is much longer than 2nd line io. 1/n https://twitter.com/tompowles1/status/1278160147240673281
Therefore the cost of maintenance io will be higher than 2nd line io. This is an important fact to take into account. Many patients in the US have significant copays for these drugs - and the potential financial toxicity is not insignificant. 2/n
Meanwhile, at a societal level, adding cost in this way, without knowing that we are adding benefit, pushes up insurance premiums, and in some countries diverts money away from other medical/public services, causing a net health loss. 3/n
Can you and other leading GU oncologists comment on how you see this issue, with relationship to the new fda approval ?
@tompowles1 @Uromigos @ERPlimackMD @Prof_IanD @brian_rini @DrRosenbergMSK @WalterStadler5
@tompowles1 @Uromigos @ERPlimackMD @Prof_IanD @brian_rini @DrRosenbergMSK @WalterStadler5
to be clear - US cancer pts have higher bankruptcy rates than people without cancer - https://www.healthaffairs.org/doi/10.1377/hlthaff.2012.1263
And here is the kicker - the endpoint that clinicians care about - mortality - those that declare bankruptcy die earlier https://ascopubs.org/doi/10.1200/JCO.2015.64.6620
And here is the kicker - the endpoint that clinicians care about - mortality - those that declare bankruptcy die earlier https://ascopubs.org/doi/10.1200/JCO.2015.64.6620
@urogeek gave a keynote speech about financial toxicity at GUASCO20, and was widely congratulated and supported. But we need to listen to what he said, and then apply it in realtime as new drugs/data arrive. @montypal @DrChoueiri
