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15-04-2019, 14:56   #61
Obvious Desperate Breakfasts
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Originally Posted by Candamir View Post
Maybe they kept you away from the clinical side of things, but a 19% response rate in no way equates to ”a drug that can extend your life by 19%”. For a start.
The problem with statistics for cancer drugs is that cancer drugs work really well for some people and not at all for others. I was on a drug for over two years before it stopped working. My quality of life was really good for those two years. I had no side effects. For others, it won’t work at all. And some of the people it hadn’t worked for that I know of have the exact same subtype of cancer as me on paper. So, what will the stats say?

And I’d challenge anyone to look me in the eye and tell me that giving me a good two years with minimal side effects wasn’t worth whatever it cost the state. I’m in my 30s. In that two years, I got married, travelled to Iceland, saw the Northern Lights, enjoyed two more Christmases, two more birthdays, laughed, loved. The next drug I try might not work for me. Or I might get another two years. Maybe more. The drug that worked for two years for me sometimes works for way longer. Some people get five years out of it.

With cancer drugs, doctors don’t know if they will work for the individual in front of them. But they have to try because it will or it won’t and if it will, that patient could buy some serious time. If I was denied drugs due to not having health insurance, I probably would have been dead six months out from diagnosis. But I’m now approaching the fourth anniversary of my diagnosis.

And it’s not just an issue of patients being given generics rather than the brand name. If it’s a new drug, the brand name will be the only one that exists.

As for why I didn’t have health insurance. The arrogance of youth. Who expects to develop terminal cancer in their 20s? Especially a cancer with a median diagnosis age of about 60.
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15-04-2019, 15:21   #62
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Originally Posted by steddyeddy View Post
No offence M but you seem to use that strawman regularly. No one but no one is saying that. Literally no-one. You sound very young but there's more to debating healthcare, education ect to saying it's rich and poor.

The complexity of healthcare is lost on yourself and a others. Most people seem to think that in this case private health care customers pay more so should be entitled to greater pay. I'll make this as clear as possible. I have experience in industry and academia in biotech. All healthcare is subsidised. No one pays the full amount for it. Some diseases such as cystic fibrosis aren't common enough to be worth researching were it not for massive government and some charity funding. The idea that an extra 1k a year for VHI should be the difference in life and death for someone with terminal breast cancer is ludicrous. It's not even a rich VS poor argument. 1000 a year isn't huge money.
But that is not the case and I think you know that we are talking about real people, not some Daily mail headline compare the tone of your posts to say the one by suger free. The response to this should be factual and evidence-based that is all.

Everyone should have the same access to health care and medication.

I have had treatment in both the private and public system and would complement both.

The big difference is things like having a private room with a nicer ambiance, less queuing, seeing the consultant, not just the consultant's team, quicker accesses to diagnostic appointments at more convenient times again with less waiting, however, the nursing and medical care was the exact same.

The perception aspect is interesting.
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15-04-2019, 15:24   #63
steddyeddy
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Well, that is a subjective word, and if you do work in academia you would wise to follow the scientific principle, not some emotive clickbaity article.
I'll say it again. A drug approved for prescription for patients with breast cancer and has shown to be somewhat effective in clinical trials has the potential to save lives.
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15-04-2019, 15:35   #64
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Well, it doesn’t necessarily mean that either, but I don’t have the full data set to say exactly what it does, or might mean.
You're looking at word semantics now rather than the pharmacology. 19% objective response rate means one thing. It wouldn't kill you to look up the data instead of relying on other people but here you are:

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The 24-week progression-free survival (PFS) rate was 27% and the objective response rate was 19%. Three of the four patients who responded to treatment are continuing to respond.
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15-04-2019, 16:16   #65
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You're looking at word semantics now rather than the pharmacology. 19% objective response rate means one thing. It wouldn't kill you to look up the data instead of relying on other people but here you are:
You’re hilarious! Accusing me of word semantics over science when you completely misrepresented the pharmacology!
A 19% response rate means exactly that - a response rate. It doesn’t say anything about what the response was. It may equate to an improvement in survival. It may relate to a drop in tumour markers, or radiological evidence of tumour shrinking. And while ‘it wouldn’t kill me’ to dig up and study the data sets, it’s not my argument, so no thanks, I won’t. Perhaps you should study it a bit better since you are using it in your argument, and seem to think it means that “this drug can extend your life by 19%”
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15-04-2019, 17:46   #66
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Originally Posted by Candamir View Post
You’re hilarious! Accusing me of word semantics over science when you completely misrepresented the pharmacology!
A 19% response rate means exactly that - a response rate. It doesn’t say anything about what the response was. It may equate to an improvement in survival. It may relate to a drop in tumour markers, or radiological evidence of tumour shrinking.
Mate maybe take a chill pill. There's no need to get so personal over a disagreement. First of all from my first post about the pharmacology and clinical trials I discussed "objective response rate" not response rate. Objective response rate (ORR) isn't the same as response rate. ORR is a term used specifically in oncology meaning the percentage of patients that exhibited a reduction in the tumour burden by a predefined amount. It's perfectly accurate to say there's a 19% objective response rate in reference to triple-negative breast cancer.

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And while ‘it wouldn’t kill me’ to dig up and study the data sets, it’s not my argument, so no thanks, I won’t. Perhaps you should study it a bit better since you are using it in your argument, and seem to think it means that “this drug can extend your life by 19%”
You're repeating the mistake I admitted to making for what purpose? It's not my argument either. The 19% ORR is referring to peer reviewed data.
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15-04-2019, 17:59   #67
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Originally Posted by ELM327 View Post
It's as if you have purposely misunderstood my post.


If I am paying for healthcare (which I am, approx 2500 per annum for couple), why would I bother if everyone is treated the same anyway??
I don't know but why would I care if the private health care business has a viable business model?
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15-04-2019, 18:21   #68
Candamir
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Originally Posted by steddyeddy View Post
Mate maybe take a chill pill. There's no need to get so personal over a disagreement. First of all from my first post about the pharmacology and clinical trials I discussed "objective response rate" not response rate. Objective response rate (ORR) isn't the same as response rate. ORR is a term used specifically in oncology meaning the percentage of patients that exhibited a reduction in the tumour burden by a predefined amount. It's perfectly accurate to say there's a 19% objective response rate in reference to triple-negative breast cancer.



You're repeating the mistake I admitted to making for what purpose? It's not my argument either. The 19% ORR is referring to peer reviewed data.

Ha ha. I’m not repeating your mistake - I’m just pointing it out to you again.
And you’re still getting it wrong. Or inferring it. Yes. It’s perfectly accurate to say there’s a 19% ORR. Because that’s what your quote claimed. Your inferences as to what that meant however, are all over the place.

And just to clarify - ORR refers only to reduction in tumour burden? So nothing at all do do with extending survival. So you just made that up (as if it wasn’t obvious by your data mashing!)

And I’m totally chilled.

Last edited by Candamir; 15-04-2019 at 18:25.
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15-04-2019, 18:28   #69
steddyeddy
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Originally Posted by Candamir View Post
Ha ha. I’m not repeating your mistake - I’m just pointing it out to you again.
Great, cheers man!

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And you’re still getting it wrong.
We'll agree to disagree here.

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Or inferring it.
What?

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Yes. It’s perfectly accurate to say there’s a 19% ORR.
Thanks for that. I feel a bit better now.

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Because that’s what your quote claimed. Your inferences as to what that meant however, are all over the place.
ORR - Proportion of patients with reduction in tumor burden of a predefined amount. Simple as that man.
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15-04-2019, 18:31   #70
Candamir
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ORR - Proportion of patients with reduction in tumor burden of a predefined amount. Simple as that man.
Yep, real simple.

Says nothing about survival, man. Which is what you’ve been trying to infer.

But look, if you want to agree to disagree.....
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15-04-2019, 18:35   #71
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I hate reading about our medical system.
It's embarrassing and sad.
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15-04-2019, 19:35   #72
steddyeddy
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Yep, real simple.

Says nothing about survival, man. Which is what you’ve been trying to infer.

But look, if you want to agree to disagree.....
Yea we will C. No offence but the fact you've edited your post to include overall survival, another end point in clinical trials leads me to believe that you've just looked it up.

True objective response rate doesn't correlate exactly with overall survival in terms of clinical trial endpoints but tumour size decrease is associated with greater survival believe it or not.

While we're at it and you want to move away from the positive overall ORR I'll link an article that shows that Atezolizumab does increase overall survival rate of some cancers such as lung cancer.

https://www.sciencedirect.com/scienc...4067361632517X
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15-04-2019, 19:42   #73
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The National Centre for Pharmacoeconomics evaluates the cost effectiveness of new medicines, and those that are cost effective are then reimbursed by the state. Based on the data submitted to them, these drugs weren't deemed cost effective for the conditions outlined in the article. This is why they aren't funded by the state for public patients. Covering these medicines would mean taking funding from other areas of the health system where it provides more benefit.

This is a dangerous precedent set by VHI, it's effectively subverting the national process for economic evaluation of medicines. It's effectively going to be a means for pharmaceutical companies to gain extra leverage in getting new medicines reimbursed at higher prices.
Thank you for posting this. Great point although in the case of these particular drugs it may be that they haven’t been evaluated by NCP yet as the trials that were used to grant the extension of license are very recent. But overall you are correct to highlight the dangers or bypassing the NCP assessment system which is probably out only non-conflicted means of assessment.
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15-04-2019, 20:17   #74
Candamir
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Yea we will C. No offence but the fact you've edited your post to include overall survival, another end point in clinical trials leads me to believe that you've just looked it up.
I did what now?

Only a few hours ago you thought a 19% objective response rate to a drug means a drug will extend your life by 19%, and I’m the one looking stuff up?

I’ll leave it there.
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15-04-2019, 20:26   #75
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I did what now?


I’ll leave it there.
Please do.
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