December 27, 2007

The International Herald Tribune ran a story on December 25th on the rush to build particle accelerators in the U.S. to treat cancer patients.

The accelerators are tremendously expensive ($100 million plus each) and it's not clear whether they are - with the exception of certain rare cancers - superior to existing treatments for the disease they will be most widely used to treat, prostate cancer.

"I'm fascinated and horrified by the way it's developing," said Anthony L. Zietman, a radiation oncologist at Harvard and Massachusetts General Hospital, which operates a proton center. "This is the dark side of American medicine."

Similar cost concerns were expressed in the past about other new technology like MRI scanners. While those have become accepted staples of medical practice, there is still concern about their overuse and the impact on medical spending.

I wouldn't call it the dark side of American technology (I'm all for medical innovation). But it should also remind us of why pharmaceuticals are great medical investments; for instance, the upfront costs are high, but after patents expire, drug prices plummet.

There's also plenty of competition within drug classes, and relatively good data (and getting better all the time) to help doctors pick the best therapies for their patients.

And if somebody invents a great drug for prostate cancer (to my limited knowledge, there aren't any good treatments outside of radiation, hormones, and surgery) it will automatically put these proton accelerators - and lots of surgeons and radiologists - out of business. That saves money in the long run, and doesn't leave you with lots of messy outdated infrastructure.

For more on this argument, see Peter Huber's Forbes article Medicine Gets Cheaper.

Undoubtedly, more of these tumor-bombing particle accelerators will get built, but the future of medicine isn't in hardware, but in software - genes and personalized medicine.

And rather than vilifying the industry, we should be doing much more to encourage this transition.

Posted by Paul Howard at December 27, 2007 03:53 PM

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