Week 47: The mind boggling R&D strategy of public hospitals in Norway

Written by Lars Haakon Soraas
17
Jul

Week 47 in the war on lung cancer has passed. Here are the highlights:

  • Dyanne has been in pretty good shape all week.
  • On Monday I travelled to Lysekil in Sweden to meet Bengt Sjöberg. Mr Sjöberg, who was diagnosed with cancer in the beginning of the year, recently announced that he will donate 200 million euro to cancer research. Like us, and many other “terminal” cancer patients, he is very interested in exploring non-proven therapies. However, with his donation, Mr Sjöberg is in a unique position to not only test such treatments on himself, but to make sure they are tested in proper clinical trials. His focus is, intelligently, on therapies that currently do not have any commercial interests backing them (e.g. old medicines that are not longer protected by patents). Or, as economists would put it, he is addressing a “market failure”.
  • I have become a Wikipedia editor. On the article on itraconazole, I added a small section on this drug’s anti-cancer properties.
  • I have had an interesting exchange with Helse Sør-Øst, the regional health trust that is charge of the hospitals in a large part of Norway (including Oslo). Here is an interesting observation: Helse Sør-Øst has very limited resources to conduct clinical trials. Most of these limited resources are allocated to do industry sponsored trials (i.e. trials that are run by pharmaceutical companies in order for them to get approval for drugs). The remaining share is allocated to investigator sponsored trials (i.e. trials that are not sponsored by the industry). Some of the drugs that emerge from the industry sponsored trials (e.g. nivolumab), Helse Sør-Øst are, ironically, not able to afford when they reach the market. So, Helse Sør-Øst chooses to spend limited R&D resources to help out doing trials with drugs they eventually are not able to afford. And, because they spend their limited resources on testing such expensive drugs, they don’t have any resources left to conduct trials to test old and cheap drugs which have promising anti-cancer activity. Such drugs (itraconazol and clarithromycin are two good examples) could, if proven in trials, not only extend patients’ lives, but also lead to massive savings on hospitals drug purchasing budgets. So why on Earth does Helse Sør-Øst use their limited resources on testing these expensive drugs? To me, this is mind boggling… If anyone can explain this, please do!

Yesterday, we drove to Båstad in Sweden and will spend the next week or two here. We are looking forward to some sun and rain and family time here!

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