Securing the Benefits of Medical Innovation for Seniors: The Role of Prescription Drugs and Drug Coverage. Cancer


  • More than 550,000 Americans will die from cancer this year. (American Cancer Society 2002)
  • The National Cancer Institute estimates that approximately 8.9 million Americans alive today have a history of cancer.
  • If the current incidence pattern continues, cancer diagnoses will double from 1.3 million people in 2000 to 2.6 million people in 2050. Moreover, during this period, the number of cancer patients aged 85 and older is expected to increase four-fold.
  • Cancer is one of the most expensive diseases to treat. In 2001, total costs for cancer were reported to be in excess of $156 billion, with medical expenditures accounting for approximately $56 billion. (American Cancer Society 2002)
  • Recent advances in biotechnology have yielded some promising new approaches to cancer treatment.

Percentage of U.S. Adults who have ever had Cancer, by Age

Percentage of U.S. Adults who have ever had Cancer,<br />
			 by Age

Source: National Health Interview Survey, 2000


Cancer is the second most common cause of death in the United States. Lung, colorectal, prostate, and breast cancer are the most common types of cancer. Although there has been an overall decline in U.S. cancer death rates, the cancer burden is expected to rise as the population ages. (NIH, National Cancer Institute 2002)

Lifetime Probability of Breast Cancer in Women in the United States

From age 30 to age 40

1 out of 257

From age 40 to age 50

1 out of 67

From age 50 to age 60

1 out of 36

From age 60 to age 70

1 out of 28

From age 70 to age 80

1 out of 24


1 out of 8

Source: National Cancer Institute Surveillance, Epidemiology, and End Results Program, 1995-1997

Treatment of Cancer

Treatment for cancer depends on the type of cancer; the size, location, and stage of disease; and the person’s general health. Drugs and biologics play an important role in the treatment of cancer. Attempts to decipher the human genome have launched an exciting new era in biomedical research with tremendous potential for cancer treatment. New drugs are now being designed to target specific molecular features characteristic of cancer cells, including genetic mutations, epigenetic factors causing changes in gene expression, structural changes in the proteins that are products of mutated genes, and derangements in signal transduction pathways. In essence, any specific difference in the molecular composition of tumor cells can become the basis for “targeted” therapy. In the future, the treatment for each patient’s cancer will be individualized based on the unique repertoire of molecular targets expressed by their particular tumor.

Percentage of U.S. Males who have Ever had Prostate Cancer, by Age

Percentage of U.S. Males who have Ever had Prostate<br />
			 Cancer, by Age


Source: National Health Interview Survey, 2000

Conventional anticancer drugs have tended to be non-selective, attacking both cancerous and healthy cells. Consequently, cancer chemotherapy is often accompanied by a variety of devastating short- or long-term side effects. Moreover, individual patient responses to conventional agents are highly variable, even in cases where specific cancers appear to be histologically identical. Molecularly targeted therapies based on recent progress in genomics and proteomics, however, hold out the promise of being far more selective, thereby drastically reducing the incidence of side effects in patients undergoing cancer treatment. (Livingston 2001)

Cancer Survival Rates, All Sites

Cancer Survival Rates, All Sites

Note: The year is the year of diagnosis or death.

Source: Surveillance, Epidemiology, and End Results Cancer Statistics Review 1973-1999; National Cancer Institute, 2002.

For example, the recently FDA-approved drug, Gleevec, which is used to treat chronic myeloid leukemia (CML), is one of the first agents using this new approach that targets abnormal proteins fundamental to the cancer. (Wall Street Journal May 16, 2002) Unlike most current cancer therapies that kill both normal and cancer cells leading to unwanted side-effects, Gleevec and other drugs in this class are designed to zero in on specific cancer-causing molecules, eliminating cancer cells while avoiding serious damage to other, non-cancerous cells. Early studies of this drug have shown that in patients with chronic myelocytic leukemia, white blood-cell counts are restored to normal levels.

Although Gleevec® is available in the U.S., other countries have restricted its use. For example, the preliminary review of Gleevec in the UK by officials at the government-sponsored National Institute for Clinical Excellence recommended that the drug only be used in patients who had already gone into the “accelerated phase” of their disease. (Hawkes 2002) In the U.S., Gleevec is indicated for treatment of patients with CML in blast crisis, the accelerated phase or in chronic phase after failure of interferon-alpha therapy.


Drugs in the pipeline for cancer

  • Drugs and biologics that target specific molecules or proteins on cancer cells are being developed. (NIH 2002, Livingston 2001)
  • Vaccines against certain types of cancer are also being investigated. (NIH 2002, Livingston 2001)
  • Drugs that prevent blood vessel growth in tumors are also being tested. (NIH 2002, Margolin 2001)

At present, many new compounds, some of which have novel mechanisms of action, are in development. In 2002, 402 drugs or biologics are in clinical trials for treatment of various forms of cancer. (PhRMA 2002)

Several new approaches to treat cancer are being investigated. Much research is underway to develop drugs and biologics that attack certain molecular targets on cancer cells, causing selective cell death. (NIH 2002, Livingston 2001) By specifically targeting cancer cells, damage to normal cells will be minimized, thus reducing the morbidity of chemotherapy.

Scientists are also studying different compounds that work with the body’s immune system to kill cancer cells. One clinical trial is evaluating the ability of an antibody to kill lymphoma cells. In other trials, agents that manipulate different parts of the immune response to kill tumor cells are under investigation. (NIH 2002)

Tumor growth is dependent on the generation of new blood vessels to maintain blood supply to cancer cells. This new blood vessel formation is called angiogenesis. Anti-angiogenic drugs that block a tumor’s ability to grow new blood vessels are in clinical trials. (NIH 2002, Margolin 2001) Finally, there is interest in developing vaccines for different types of tumors, such as colon cancer and melanoma. (NIH 2002, Livingston 2001, American Cancer Society 2002)

View full report


"innovation.pdf" (pdf, 708.29Kb)

Note: Documents in PDF format require the Adobe Acrobat Reader®. If you experience problems with PDF documents, please download the latest version of the Reader®