A public fund for trials that test less treatment
No company will pay to find out whether six months of its drug works as well as twelve. A dedicated public fund would pay for those trials, which save patients side effects and health systems money.
A ring-fenced fund (national research agency or philanthropic) that only supports randomised non-inferiority trials of shorter duration, lower dose, fewer cycles, omitted components or less frequent dosing of approved therapies, with a standing statistical and design core and pre-agreed non-inferiority margins co-developed with patients. Precedents: PERSEPHONE (6 vs 12 months trastuzumab), SOLD, and low-dose abiraterone; funders such as the UK NIHR HTA programme and the Anticancer Fund have supported some.
- Trial design, endpoints and cost · A phase 3 trial takes years and hundreds of millions of dollars, and often answers a question that has already moved on.
- Toxicity and quality of life are undervalued · Trials measure how long people live, not how they live. Side-effects are under-reported and under-treated.
- Incentives reward me-too drugs and marginal gains · The system pays the same for a drug that adds two months as for a cure, so companies race to copy rather than to cure.
Pages like this
not linked directly; found by shared links- IdeaAn abbreviated approval path for follow-on antibodies within a validated class
Shares Trastuzumab, Incentives reward me-too drugs and marginal gains, Trial design, endpoints and cost, Pembrolizumab.
- IdeaA permanent platform trial for supportive-care interventions inside cooperative groups
Shares Trial design, endpoints and cost, Toxicity and quality of life are undervalued.
- IdeaDisclose R&D and manufacturing costs of publicly funded cancer drugs to get coverage
Shares Incentives reward me-too drugs and marginal gains, Cancer Research UK.
- IdeaPublish per-patient trial cost benchmarks and target halving them
Shares Cancer Research UK, Trial design, endpoints and cost.
- IdeaTolerability as a co-primary endpoint with its own label claim
Shares Trial design, endpoints and cost, Toxicity and quality of life are undervalued.
- IdeaDefine tolerability endpoints as rigorously as efficacy endpoints
Shares Trial design, endpoints and cost, Toxicity and quality of life are undervalued.
- IdeaRandomised trials of stopping immunotherapy after one year versus continuing
Shares Trial design, endpoints and cost, Toxicity and quality of life are undervalued, Pembrolizumab.
- IdeaExtra exclusivity for sponsors who run treatment-duration and de-escalation trials
Shares Incentives reward me-too drugs and marginal gains, Toxicity and quality of life are undervalued, Pembrolizumab.