Saturday, 18 May 2013

Public and private can make excellent bedfellows, especially in treating cancer

I was recently asked to write about the future for my latest blog in Health Insurance Magazine and I included a plea for increased cooperation between the public and private sectors. As I wrote ‘There are still some Neanderthals out there who subscribe to the public good, private bad mantra’

I experienced a fantastic example of private and public partnership a few weeks ago when I attended the launch of a molecular screening laboratory in London’s University College (UCL) Cancer Institute. The technical detail of this collaboration between Sarah Cannon, the cancer arm of Hospital Corporation of America (HCA) International and UCL Advanced Diagnostic, part of the UCL Cancer Institute is described in more detail in their press release:

This is the coming together of an NHS Hospital (UCL) and an American Healthcare company (HCA) to research and treat a range of cancers. The mission of this venture is to enable patients to ‘live with cancer’ through a patient centred approach. No this isn’t the ‘patient centred’ sound bite often quoted by politicians and health officials – this is personalised medicine - the patient focussed analysis which identifies the genetic drivers for specific cancers. In a nutshell, the genetic abnormality which triggers the cancer is identified through molecular profiling undertaken in this joint venture laboratory. The techniques used can now sequence multiple genes in the fraction of the time previously required. Traditional biopsy assessment can be supported with genetic pathway analysis leading to individual treatment regimes saving time, money and lives.

Multiple clinical trials will establish the appropriate treatment pathways and this cancer screening unit gains its income from a variety of sources including charities, research organisations, government funding and drug company sponsorship.

Patients, often with little hope of cure or even a short term future, will be given the lifeline of this molecular screening to find the best possible chance of addressing their genetic abnormality to offer an improvement in longevity and quality of life.

This laboratory is targeting 11 (rising to 35 by July) genetic abnormalities using samples collected from a traditional biopsy. Patients will be admitted to clinical trials from a variety of sources (NHS, research establishments and the private sector) and the initiative is, in my opinion, a significant good news story.

Several major points struck me as I attended this press launch.

Firstly, the genuine passion and commitment of the key clinicians and executives. If you have to face cancer, I can think of no better individuals to join your armoury for your personal battle. Backing professional conviction with hard facts and a heavy dose of realism, the clinical team from UCL and HCA and senior executives from Sarah Cannon seemed to find the right words to inspire and convince. Professor Chris Boshoff saying ‘the future is now available in this laboratory’ managed to avoid sensationalism in his tone and Dr Howard Burris, president of clinical operations at Sarah Cannon referred to this speeding up of tailored diagnosis as a ‘game changer as we speed up the development of novel therapies’. Exciting stuff.

The second key point was the space, manpower and technology available in the pristine laboratory premises. These impressive facilities simply could not have been provided by the public sector alone.

Thirdly, with disappointment I noted that one journalist (but only one I’m pleased to report) was intent on finding the downside of this development. She started her questioning with the comment ‘I’m sorry to be cynical but…’  Of course she wasn’t sorry at all as she harped on about the NHS not being able to fund this initiative and suggested that NHS patients would not be referred to the facility. Regular followers of healthcare news will know the high-circulation tabloid well – it constantly sensationalises health reports and often focusses on the bad, rather than good news stories. The speakers responded to her with courtesy and patience. The point which she chose to miss was that eligible NHS patients presenting with one of the cancers under investigation at the unit will be enlisted in clinical trials as appropriate. Their cancer tissue, collected from traditional sampling techniques can be sent to this laboratory for testing and their tumour signature identified within 7 days. The cost of this is marginal compared to the amount of money saved though inappropriate treatment and the human cost of repeat biopsies and wrong pathways. Add to this the income generated from funded research and additional sponsorship and this is a laudable public private venture.

Dr Burris struck a chord with me when he said that the biggest cost in drug development is time. This is also the most precious currency of any cancer patient. The ground-breaking molecular screening speeds up the voyage of discovery for cancer diagnosis and tailored therapy and can buy precious days, weeks and years for cancer sufferers.

As one patient who, after ten years of toxic therapies, has benefitted from newly targeted drug treatment for his rare cancer said ‘I feel like a normal human again’. However mealy mouthed or cynical you may be about public private partnerships in health – this is a powerful testimony in favour.



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