NorthWest Biotherapeutics Inc (NWBO)

[biosectinvestor]

And yet, governments in various places have not been convinced by the Novocure data and will not pay for the treatment because it is viewed as ‘not an efficient use of ... resources’. This is specifically true of the UK government's expenditures. Optune is approved, but is not covered by the NHS. It is viewed as basically not worth the expense, and it seems they were not convinced by the data, which was not collected over 5 years but was hypothetical.

And I believe some others have done some research to find that in fact, there were no actual "beating hearts" out there at 5 years, but that may just be for other trials that statistically made that claim but turned out not to have any actual "beating hearts".

https://www.dailymail.co.uk/health/article-10679311/NHS-refuses-fund-mother-twos-brain-tumour-zapper-not-cost-effective.html

In 2018, spending watchdog the National Institute for Health and Care Excellence (NICE) ruled against offering Optune to NHS patients, claiming it was ‘not an efficient use of NHS resources’.

The other problem is they say in these articles that it is a $240,000 treatment, but I believe that is PER YEAR, not that it actually stops the cancer if you wear it one year, but that you have to wear it most of the day, including when asleep, for the rest of your life.

So the cost could add up quickly, to many hundreds of thousands of dollars if it in fact behaves as claimed. Personally, if it extends the life of 13% of the patients, it might be worth it, but I believe, because the statistics are hypothetical, it depends upon the ability of a patient to maintain compliance for 5 years.

And of course the Washington State government made a similar conclusion here:

https://www.hca.wa.gov/assets/program/tumor-treating-fields-final-report-20181016.pdf

Conclusion
Findings are based on a small body of evidence graded as low or very low certainty because of a paucity of RCT data and comparative observational studies that we rated high risk of bias. We conclude with very low to low certainty that the addition of TTF to usual care with TMZ increases overall and progression-free survival among patients with newly diagnosed GBM. For patients with recurrent GBM, there may or may not be survival benefits associated with TTF treatment with or without second-line therapy (very low certainty). We conclude with very low certainty from CT data that TTF improves quality of life and functional status among patients with newly diagnosed or recurrent GBM. We found evidence of minimal harm attributed to TTF treatment for GBM; TTF is likely safe for newly diagnosed and recurrent GBM (very low to low certainty), though likely not cost-effective for newly diagnosed GBM (low certainty). We found no evidence on which to draw conclusions about the cost-effectiveness of TTF for recurrent GBM or the impact of TTF treatment on non-GBM cancers.

Thanks to Hoffmann, who pointed out this report a few weeks ago again:

https://investorshub.advfn.com/boards/read_msg.aspx?message_id=169574535.

And of course there are patients who can't wear it... and here's a little on the cost:

A patient is also unable to use Optune if he or she has skull defects. “If there are defects where the skull is missing or had to be removed for a specific reason, they can’t wear the device,” he says.

Then there’s the cost: The Optune device costs about $21,000 per month.

“The problem is that because this is something that you have to wear all the time, and if it’s working, it really shouldn’t be discontinued unless a patient has been totally stable for many years,” Dr. Khagi says. “Frankly, we don’t know how long we need to wear this device. That really does add to the cost, because let’s say patients are doing very well—there’s going to be very little incentive for me to want to stop it as a physician. I’m sure patients would also be reluctant to stop it if they know that this is the only thing in their lives that is potentially keeping this disease at bay.”

There is a difference between this kind of device and an immunotherapy that equips the body itself to find and fight the cancer cells and to destroy them. You get your treatment and you go in every 6 months for 3 years and then those people in that 13% may never have glioblastoma again or it may not come back for many years. 5 years without intervention is, in the case of a systemic treatment like DCVax-L, more along the lines of a "cure", whereas Optune is more like a permanent bandaid that affects people's quality of life and requires complete compliance always to prevent the tumor from coming back. A slip-up, and the patient likely feels guilt if the tumor comes back. Really not ideal.

I could see these as complimentary, if a patient wanted to wear one and take DCVax also, but the risk is that the patient really is cured by DCVax-L, maybe even they got Poly-ICLC and Keytruda, but they feel they need to keep wearing that cap because they are so fearful of not having that leather cap which may or may not have been responsible. Now you've got someone uncomfortable, waring this cap, forever, paying $21,000 a month, forever. I think that would be the worst of all possibilities.