Thanks so much for the explanation Rich.
<rant on>I think ignorance is one of the worst aspects of the bad part of life; if we understand the 'due process' it probably doesn't look as bad as it does when waiting for some treatment, which has already been developed, to trundle through the process.
Patience is NOT a virtue for patients who will be dead in a month or a year if they don't get treatment. If a product causes a bit of neutropenia, dammit, or a faint fever and facial flushing in a few people [who can't be determined beforehand], it seems a good risk balance compared with the alternative. Better Red than Dead say I.
Rituxan adverse effects seem trivial and many of the people being treated must be quite old and susceptible to any burden from treatment. But even in them, the risks seem low and painless. So the slow uptake is puzzling.
The value of human life, unfortunately, does not amount to the cost of Rituxan treatment for most of the people in the world who get treatable lymphoma. That is apparently the case in New Zealand and will certainly be the case in much of Asia and Africa. With India's GNP per capita of a few hundred dollars, they won't be able to afford $$thousands for Rituxan or Zevalin. I suppose the issue doesn't arise as much as you'd think with 1bn people because life expectancy is still low, so I suppose the proportions with lymphoma are much lower than in the longer-lived countries. In Africa, hordes die from AIDS and other diseases before lymphoma gets a chance [being predominatly an older-age problem].
Well, on that unpleasant note, I'll go read some WWeb stuff.
I suppose 'due process' is just an annoying fact of life to some extent, but we should never let a bit of shroud-waving conceal what might really be bureaucracy at it's worst. "Safety you know!", is the fashionable catchcry of people who are really just interested in exerting authority and doing things their slow, comfortable and profitable way. It's an easy out for them. We are all expected to agree, "Oh yes, Safety. I forgot. Yes, we can't compromise safety." Then not take a closer look.
We don't want ambulances running over children at 200kph on the way to rescue somebody who has got a broken arm or even a life-destroying oxygen loss. Yes, due process has it's place. But it's interesting that tow-trucks, which operate on getting to the accident first to get the tow and make the money, invariably beat the ambulance to the scene. That seems to me to mean that due process is not working right! Ambulances should be able to be there first - a minute matters. Actually, when holding one's breath or short of oxygen, 10 seconds matters! Maybe they need some competition. </rant off>
Since lymphoma isn't a single variable disease in even one person, with a wide array of cell-types, it seems obvious that unless something like telomers can be targeted, a multi-treatment makes sense [and would cost a lot more - what's a person-month worth?...depends on the person].
Maurice |
