Since the 2015 launch of the Cancer Moonshot programme in the US, substantial progress has been made to find cures for different types of cancers. With a focus on precision medicine, scientists are moving closer to identifying “patient-specific” cancer treatments that is set to significantly prolong life or even cure the disease.
This sense of urgency could be the result of statistics telling us that cancer is the second leading cause of death worldwide and that the number of new cancer cases increased by 33 per cent in the past 10 years.
Precision medicine consists of analysing subgroups of people with similar genetic characteristics and how their environment and lifestyle impact their health which could result in similar reactions to treatments.
Hope springs eternal
By having a thorough understanding of how the above mentioned factors impact individuals’ health, doctors are in a much better position to diagnose the early onset of diseases like cancers and prescribe the most effective treatment.
A recent example of this includes bioengineers at the University of California who developed a new blood test that could detect cancer earlier, and locate where in the body the tumour is growing.
Also, doctors can even target advanced cases of specified cancers with tailored treatments that can prolong life significantly or even cure the disease. One such example includes former US president, Jimmy Carter, who was diagnosed with an advanced brain tumour in 2015. Just over six months later he announced that his brain tumour had disappeared as a result of chemotherapy and the use of a new precision immune therapy cancer drug called Keytruda which stops tumour cells from cloaking themselves against the normal, healthy immune system response.
However, the average cost for one year’s treatment could easily amount to $150 000 per patient.
The reality of cancer
Cancer is an extremely expensive disease to treat and medical aids were not really designed to address such treatments. Added to this is the cost of cancer treatments vs. the quality of care that is provided, meaning how well individuals respond to cancer treatments, taking into account the side effects, and how many years it actually adds to their lifespan. This is where precision medicine can make an immense difference when it comes to increased success of cancer treatments, limited side effects and the cost-effectiveness of the treatment.
Even though our understanding of precision medicine is still in its infancy, it is well on its way to evolve into targeted treatments with verifiable outcomes - but those treatments are the ones that are very costly.
A comprehensive approach
“Looking at recent media coverage where various pharmaceutical companies are scrutinised by the Competition Commission because of the high cost linked to “new- generation” cancer drugs, it serves as a strong reminder why it is vital to have comprehensive critical illness cover”, according to George Kolbe, Head of Marketing for Life Insurance at Momentum.
He adds that comprehensive cover can provide clients access to these new generation drugs and tailored treatments. With more than 3 000 women dying from breast cancer every year in South Africa, one new generation drug called Herceptin was specifically designed for the treatment of patients with HER2 related breast cancer. This drug is very expensive and can easily cost half a million rand for a year's treatment.
Most medical aids will only provide it if a medical panel approves it and then capped limits will apply. The great news is that a biosimilar (generic) of Herceptin was produced in India but this is not available in South Africa. It is important to take into account that research costs linked to the development of precision medicine is very high and will remain so in the long run. Kolbe states that this is why sufficient critical illness cover remains a non-negotiable, especially in a country like ours where we do not have a regulated national health system”.
He adds: “From an insurance point of view, precision medicine does open up new avenues with regards to the way that critical illness cover is structured, especially with early diagnosis. With affordability always an important consideration, it is vital for insurers to provide both tiered pay-out critical illness cover options and options that pays 100 percent earlier on, with both options covering the same events. Selecting the tiered pay-out options ensure that higher cover amounts are more affordable and the financial needs of clients are met as they arise; paying out a smaller percentage on diagnosis of lower severity events and more, if and when the event progresses.
Therefore, comprehensive critical illness cover offers clients more choices based on tailored preferences rather than generic availability”.
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