It's Time to See Just How Serious President Biden is about Defeating Cancer
By Kenneth E. Thorpe
We're well into year two of President Biden's reignited Cancer Moonshot. The $1.8 billion initiative, which then-Vice President Biden helped launch back in 2016, aims to cut the cancer death rate in half over the next 25 years while improving quality of life for cancer patients and survivors.
Unfortunately, one of the president's signature accomplishments -- the Inflation Reduction Act -- could make it harder for the country to meet the Moonshot's ambitious goals.
The IRA made transformative changes to America's economy. It funds hundreds of billions of dollars in clean energy investments, expands tax credits for Americans who purchase health insurance through the Affordable Care Act, and -- for the first time -- caps how much Medicare enrollees will have to spend out-of-pocket for prescriptions.
The law also allows the federal government to set the prices of prescription drugs purchased by Medicare. Considering that the federal health insurer pays for about 30% of all U.S. prescription drugs, these price caps will reduce biotech companies' revenue by tens of billions of dollars annually -- and thus disincentivize future investment in pharmaceutical research.
Cancer research, in particular, will take a severe hit. A University of Chicago study predicted that spending on cancer R&D would decrease by $18 billion annually due to the IRA.
We're already seeing that happen in real time. Over 80% of biotech firms recently warned the law will have "substantial impacts" on their research and development decisions. Some have already canceled clinical trials that were previously planned, concluding that further investment in certain experimental drugs no longer makes financial sense, given that it takes $2.8 billion, on average, to bring a single drug to market, and more than 90% of all drugs don't make it past human trials. New cancer treatments have a less than 6% likelihood of approval.
The IRA's provisions are especially harmful to cancer research because the law gives preferential treatment to large molecule "biologic" drugs that doctors inject or infuse into patients, compared to small molecule drugs that patients can take themselves as pills at home. Already, one major drug company dropped a promising small-molecule blood cancer treatment from the development pipeline for this exact reason.
Some of the most promising cancer therapies are small molecules, which will see less investment unless Congress and the Biden administration put small and large molecule drugs on an equal footing.
America's favorable policy environment has made it the world-leader in biotech innovation. It's a key reason why the United States has a lower per capita mortality rate for cancer than countless other developed nations, and why mortality rates have decreased steadily over the past 45 years. Without so many new treatments, America wouldn't be home to over 18 million cancer survivors.
Unfortunately, that progress could soon slow dramatically. President Biden's Cancer Moonshot is a worthy initiative. But its nearly $2 billion investment will be dwarfed by the massive reduction in R&D caused by the Inflation Reduction Act.
President Biden is unquestionably sincere about wanting to win the war on cancer. But victory requires more than just desire. It also requires smart policy. Unless Congress and the administration amend some of the most damaging provisions in the law, patients will never see the benefits of promising cancer treatments on the horizon.
Kenneth E. Thorpe is chair of the Department of Health Policy and Management at the Rollins School of Public Health, Emory University. He is also chairman of the Partnership to Fight Chronic Disease.
