What is a moon shot? Doesn't they have to do with when when we put a man on the moon in the nineteen sixties and making achieving a dream of something that seems impossible sounds like a good explanation. Hi, and welcome back to Bloomberg Benchmark, a podcast about the global economy. It's Thursday, June thirty. Spoiler alert, this is not a show about Brexit. There'll be plenty of time to talk about Brexit. We're going to deal with a more somber, more fundamental theme this week. But first I'm
Daniel Moss, executive editor for Global Economics. This week in the studio is Scott Lanman, my colleagues. Scott, tell us a little about yourself. Yeah, I've been an economics reporter and editor at Bloomberg for worth than ten years, with three of those years in Beijing editing our coverage of China's economy. Well, that's a very special economic skill to have.
But our show today is special for another reason. We're participating in Bloomberg's Focus on Farma, a monthlong deep dive into the world of farma and biotech that leverages the power of Bloomberg data analytics and editorial content a cross platforms to offer hopefully some pretty sharp insights. Scott, are you ready for some leveraging? I I sure am, and let me tell you the topic of our show today is the economics of cancer. As you know, Dan, I
have a very personal interest in this issue. My sister Cheryl died last year at age thirty four, three years after being diagnosed with breast cancer. And in addition to that, my wife carries one of the b r c A genetic mutations, which greatly increases one's risk of breast cancer and ovarian cancer. She has actually undergone several preventive surgeries over the past year to reduce her risk because her aunt, grandmother and great grandmother all died of breast cancer relatively
young ages. And if that gene and treatment sound familiar, it's because it's similar to what Angelina Julie did, because she's also a carrier and her mother died of ovarian cancer. Scott, You've got a unique perspective, and you know, I just want to say, on behalf of the economics team, we appreciate the dignity with which you've conducted yourself through this ordeal and whatever support you and Rachel need you're going to continue to get We're going to talk about some
stats regarding cancer, some of the main issues. We're going to talk about the Vice president's famous moon shot, how it got that name, and how this fits into well the global economy. Cancer is actually it's the second leading cause of death in the United States, just a shade behind heart disease, and according to some measures, it's the
number one cause of death in the entire world. But one study suggests that the total economic impact of premature death and disability from cancer worldwide is nearly one trillion dollars, or put another way, one point five pc of global GDP.
It's more than the economic toll from heart disease. And right now, that's some GDP we could shore us and speaking of our focus on farmer Worldwide, spending on cancer drugs reached a hundred and seven billion dollars and may rise all the way to hundred and seventy eight billion dollars by Spending on cancer drugs in the United States
is up seventy two in the last five years. Or President Obama earlier this year announced a cancer Moonshot initiative led by Joe Biden, which aims to cut through some of the red tape and rivalries among drug companies with the idea of speeding up the pace of some of these advances. Before we get into that, first of all, why is it called the moon shot and what is
a moon shot? Doesn't that have to do with when when we put a man on the moon in the nineteen sixties and making achieving a dream of something that seems impossible sounds like a good explanation. Well. In fact, just this week, the Vice President is hosting National Cancer moon Shot Summit in Washington, and similar events are being held around the country. As you may know, also Biden
lost his son to brain cancer last year. To help us sift through all this, were joined on the phone by Dr Lewis Wayna, director of the Georgetown Lombardy Comprehensive Cancer SANTA in Washington. He's also chairman of the Department
of Oncology at Georgetown. Interesting fact, the SANTA is actually nineful legendary football coach Vince Lombardi, who was treated for cancer at the same and Dr Wiener is also a member of a Blue Ribbon Panel working group on the Cancer Moonshot Initiative, tasked with focusing on immunology and prevention. In the interest of full disclosure, Georgetown is where my
wife underwent her preventive surgery last year. Also, our boss, the owner of this company, Mike Bloomberg, wrote an op ed with Vice President Biden recently about how the Moonshot Initiative and public private partnerships can help cure cancer, and he has donated substantial funds towards cancer research. Dr Weener, thank you so much for joining us today. It's my
pleasure to be here. Let's just start first of all, Dr Weener, can you tell us about the state of cancer care and what kinds of advances are going on
and why it's an exciting time right now. So I think it's important to understand that while obviously humans have been at war with cancer throughout human history, the formal war on cancer was declared by President Nixon in one and at that time there were roughly a million new cases of cancer in the United States and about half of those patients were succumbing to the disease at some point, so there was a generally cure rate because surgery can
be very effective to eliminate cancers at an early stage. Here we are now after forty years of dedicated effort with intense federal support over those years, and dramatic expansion of the pharmaceutical industry to test new concepts and ideas that emanate from research. And roughly one point six million Americans get cancer every year, And that sounds bad at
first blush. However, it's important to remember that the population in its states has increased dramatically since so that the rate of developing cancer is certainly no higher than it was back at that time. And about five thousand people will die of cancer this year, So the number of cancers has increased by more than fifty in the death rate has remained relatively constant, suggests what has actually decreased dramatically forgive me, so that roughly two out of three
almost patients with cancer are now cured. Now, that sounds like modest progress, but when you think about it in terms of the number of lives that have been saved and on a yearly basis because of advances in cancer research and care, it's several hundred thousand Americans a year who are being cured of a disease that would have likely taken their lives only forty years ago. Now, the other exciting news in that regard is that the death rate from cancer has reduced every single year since, again
a reflection of advances in research, education, and care. And we are very pleased to have been a part of these great advances, but we obviously have quite a bit of work left to do, and what's happening in the recent few years has really been extraordinary in terms of a deepening understanding of what causes cancer and a better understanding as well of what some of the molecular targets might be that we want to attack in cancers in
order to improve treatments and ultimately cure patients. Now that's the US picture. Doctor has the death rate declare mind Similarly, outside the United States, the death rates around and you know, I don't know those numbers as well as I do
for the United States. I think that the world is a very large place, and I think that in the more developed countries such as Western Europe and Japan, it's quite likely that we're seeing similar improvements in outcome because those areas of the world have access to sophisticated care and can benefit because they are wealthy enough societies to benefit from the advances with new therapies that are being developed the rest of the world. It's not such an
easy situation. Uh. And I believe that especially as poverty continues. Yet there the poverty is lessened to the point where folks can live longer because they're not dying of infectious diseases, for example, the cancer burden increases and there's inadequate ability to actually treat those people properly. So the cancer burden around the world is still quite enormous and is not
satisfactorily addressed by current strategies. Now, that leads into a topic that we often talk about in our economic coverage, which is the widening gap, the inequality gap, wealth gap throughout the world. Uh, it sounds like what you're talking about is almost like a cancer care gap between the wealthier societies and the poor societies. Is that something that's happening or is likely to happen as the cost of
these new treatments goes up. So I'm not an expert on that specific area, but it is my um perspective and and and uh and belief based upon what I have read and heard and discussed that the availability of sophisticated therapies and even basic even fairly basic screening strategies is so much better in the developed world that the gap in care between the wealthier societies and less wealthy societies is, if anything, going to grow as we develop
more exciting and effective therapies for cancer therapy, for cancer treatment that are really predicated on the assumption that the society has enough resource to pay for it. You spoke a few minutes ago about the declining death rate here in the United States, and I'm wondering whether to get it significantly lower than where it is here, we need to jump a wall. That's a very interesting question. The the death rates are declining, they've been declining when at
a relatively even slope over the last twenty years. We all would like to see those rates drop in a more precipitous way, and the way to do that is by addressing several different areas. The first of those areas is to assure unit form access of quality care and access to transformative therapies for all people, irrespective of their economic or social conditions, and that, of course is an ongoing uh the challenge, but I think it's one that
we're very mindful of. The second is to continue to invest in um transformative research so that we can in fact continue to make the kinds of discoveries that are going to change the trajectory of cures. And I'm going to give you an example of that. So one of the most exciting new areas of cancer research and cares in the area of immunotherapy, which can be described as treating the body's immune system, so the immune system can
go ahead and treat the cancer. And it's been demonstrated the cancers erect a variety of protective wall to prevent the immune system from attacking them. And if we can identify what those particular mechanisms are in any given individual and attack those defenses very specifically, you can break them down and in fact the immune system can then eliminate
the person's cancer. And so there have been extraordinary clinical benefits for people with advanced melanomas and many other cancers with so called checkpoint antibodies developed by a number of pharmaceutical companies based in the United States. And these treatments have the capacity to cure people with advanced metastatic cancers that were otherwise going to kill them very very rapidly.
So this has really been uh like an electric shock in our field in terms of being able to um excite investigators and patients and doctors and really give us a sense of what the future could look like. This is all the result of very painstaking research, and I might add was research that many people didn't think was going to be productive for many many years, and it was only because enough money had been placed into the research and development pipelines both within academia and employment, that
these kinds of transformative advances were possible. So I think that the greatest challenges we have the wall that needs to be jumped, and this is where what we're doing today is perhaps a little bit different from the moonshot initiatives of the nineteen sixties, where it was necessary to put a man on the moon, is that in that ladder circumstance, we had the technology and we knew how
to build rockets. We basically knew what had to be done to get somebody on the moon, and it was just a huge amount of work to make it happen. In the area of cancer research and care, we have some of the tools we need to be able to make transformative advances, and in fact that the great progress is being made, but there's still additional knowledge It needs to be created in order to be able to really take a where we want to go, and that's going
to require continued investment. Now that sounds really exciting, doctor. How are you going to pay for these advances? You talk about funding for research, but there's also the cost on the other end to the patients. How are patients going to pay for it? How is our medicare system going to keep paying for these kinds of treatments? Are
our patients able to pay for these treatments? Now? Are you seeing any streams yet at Georgetown in terms of insurance or medicare not covering these kinds of new treatments that doctors are recommending. So it's a very good question and a very complicated question, obviously, and I'm gonna try and break it down into several different components that if
I could. Firstly, let's remember that the as as was mentioned earlier, the cost of cancer to the society in terms of lost wages, lost productivity, destructure, the family, family structures is just unimaginably high around the world, and we have to always think about the costs in that context. Remember that in the United States, in the next two days more than three thousand people will die of cancer.
That is an unacceptable rate of death. It is if this was happening from any other cause, I think that the American people would be justly outraged and would demand action, say what do we need to do to fix this and fix it more rapidly. We certainly do that in many other spheres when it involves national security, for example. So I think that when we talk about how expensive
cancer care is, let's also remember how expensive cancer is. Secondly, I think it's important to recognize that when you have treatments that really work well, the ultimate cost is going
to be less all aroun out. I think one of the real challenges we faced in the field of cancer care and the cost of cancer care, as we've had a number of expensive treatments that were approved that created marginal benefits for patients with cancer, and that makes the ultimate cost of cancer very large and perhaps and perhaps
it's not as cost effective as it should be. But as we develop more effective therapies, and as we develop additional disciplines that allow us to only use those treatments that are likely to have major benefits to our patients, I think that we will find that treatments are in
fact not only affordable, but desirable because it benefits society. Thirdly, with respect to how insurance companies are dealing with with with these costs at this point in time, I would say that when we are using these agents for their approved indications and patients who have the kind cancer where these treatments have been demonstrated to be effective, I have
not run into any major challenges. Certainly, the insurance companies, which are always looking to control their their expenditures, are examining these requests quite carefully and are likely to deny the requests if there if these are based upon physicians intuition or belief and not supported by data, but that's
perhaps not that inappropriate. I think that as we move forward, though, we're going to be dealing with some real big challenges, because, for example, the drugs targeting one of these immune checkpoints which can get that either the PD one or PDL one immune checkpoint molecules. We find that these drugs can work and maybe twenty five different cancers, but they don't work in every patient with each of these twenty five cancers.
They work in some of the patients with each of these twenty five cancers, So you can imagine there will be some significant challenges when thinking who should be treated with these drugs and how are we going to be able to pay for it when we know that not everybody with a particular disease as we currently understand it,
is going to benefit from these expensive therapies. And that's where additional research is absolutely necessary so that we can in fact begin to hone in one of the subpopulations of patients with a particular cancer who might benefit from a particular expensive therapy. So the answer to your question is it's complicated, Dr Wyna. Thank you so much for sharing your perspective with us, And complicated though it may be, it's vitally important and you've addressed some big themes here.
Thank you, Thank you well, Scott. That was quite a tour to force. And you know, it's just a reminder that economics is a personal thing. It's not just GDP, it's not just non farm pay rolls, it's not just an f O MC just sasion once every six weeks, right, And there's more dimensions to the economy than just these kinds of things that we think about about stimulus and central banks and jobs that there's there's six billion people and each of them have have a risk of cancer.
They can get disease, they can die, and that affects their productive capacity in the world, but also their personal connection to their loved ones and everyone else. It makes me wonder whether the economics profession and those of us who write about it perhaps sometimes get too focused on the stats and not enough attention is paid to the human equation which underlies it all. I think that that's a good point down And you know, we do pay attention.
We try to pay attention to the human equation here at Bloomberg, but there's also value in taking a step back and figuring out the big picture. And sometimes one way to understand cancer is to focus on the big picture and to see these kinds of trends and to figure out, all right, should we put this money and how are we going to pay for it? Because that's the way that our society is going to get better over time. Well, I want to thank you for your
candor here on the show. I know some of this hasn't been easy for you, and you know continued God speed to you and Rachel and the journey that your family walks on. Thank you for your support down I really appreciate it, and thanks to all of you for listening to us on Bloomberg Benchmark. Will be back next week. Until then, you can find us on the Bloomberg terminal and Bloomberg dot com, as well as iTunes, pocket Cast, Stitcher,
and Google Play. Why are there? Take just a minute to rate and review the show so more listeners can find us. Scott's on Twitter at wait for it, Scott Landman. That's all it is. Spell it for us, s C O T T l A N M A N. You can get met at Daniel Moss, d c Acchi and Tory will be back with us next week. See Ye're in