Great post! Very interesting and valid points—ran your post through AI for some follow-up discussion…
“Yes, this is a reasonable argument, and it is well-constructed for advocating DCVax’s potential benefits to the National Institute for Health and Care Excellence (NICE). The points raised are grounded in the broader context of cost-effectiveness evaluations used by healthcare systems like the NHS. Here’s an analysis of why this argument is strong and persuasive:
1. Holistic Cost Analysis
The argument correctly highlights a common flaw in cost evaluations—focusing solely on the upfront cost of a treatment without considering the broader implications on healthcare spending. The mention of reduced supportive care costs due to the low incidence of serious adverse events (SAEs) is a compelling point: • Supportive Care Savings: The reduced toxicity profile of DCVax compared to chemotherapy, radiation, and other immunotherapies like CAR-T could significantly lower hospitalization, management of side effects, and long-term care expenses. • Palliative Care Costs: Suggesting that more patients could potentially be cured or experience prolonged survival further strengthens the case for reducing overall costs, as palliative care for terminal patients is a significant financial burden on the NHS.
2. Safety Profile
The data from the Phase III trial, where over 2,100 doses resulted in only five SAEs, with none classified as life-threatening or fatal, supports the claim of DCVax’s unprecedented safety. This argument effectively differentiates DCVax from other high-cost therapies, such as CAR-T, which often come with severe immune-related adverse events (irAEs) that can require intensive and expensive management.
3. Comparison with Approved Therapies
The reference to NICE’s approval of brexucabtagene autoleucel underlines the feasibility of approving expensive but transformative therapies under managed access agreements. Drawing a parallel to CAR-T treatments with significantly higher costs (e.g., ~$530,000 per infusion) effectively positions DCVax as a comparatively cost-effective and safer option.
4. Evidence-Based Appeal to NICE’s Priorities
NICE considers cost-effectiveness in terms of quality-adjusted life years (QALYs), which combine the length and quality of life gained from a treatment. By emphasizing DCVax’s potential to improve survival rates with fewer adverse events, the argument aligns with NICE’s framework for assessing the value of new therapies.
5. Strong Emotional Appeal
The inclusion of terms like “Yes, cured!” while somewhat bold, draws attention to the potential paradigm shift DCVax could represent in cancer treatment. While NICE’s evaluation process is evidence-driven, this emotional appeal is relevant to public and stakeholder support for funding such innovations.
Potential Enhancements
While the argument is strong, it could benefit from further substantiation and clarity: • Comparative Data: Including direct comparisons between DCVax and the cost burdens of chemotherapy, radiation, or CAR-T in specific metrics would enhance the persuasiveness. • Economic Models: Citing or referencing health economic studies projecting the savings DCVax could provide to the NHS over time would provide further credibility. • Balanced Tone: Phrasing like “Yes, cured!” could be softened slightly to maintain a more neutral and authoritative tone while preserving the enthusiasm.
Conclusion
This is a strong and reasonable argument for DCVax’s inclusion in NICE evaluations. By addressing the holistic costs of care, emphasizing DCVax’s safety profile, and contrasting it with other approved therapies, the case is well-aligned with NICE’s decision-making framework. Incorporating data-driven evidence and maintaining a professional tone will further strengthen its credibility.”
I believe NICE should also be aware that in due course (in it's forthcoming combination forms) DCVax will ultimately actually save the NHS money. Naysayers only look at the probable cover price of DCVax and compare it directly to existing drugs instead of whole treatment regimes thereby failing to take into account the vast additional costs associated with adjunctive/ supportive care from chemotherapy & radiation toxicity as well as immune-related adverse events (irAEs) from immunotherapies. ...
NICE certainly does take into account entire treatment costs, What you ignore is that -L is used in addition to the current SOC and all associated costs. And the patients will have similar side effects as SOC.
People can keep on talking about hype of future protocols, but what NICE will go by is actual studies protocol. That is surgery followed by chemo rad, Then chemo plus -L. So the costs will be completely additive,
Baxers, Great post again! Adding onto the many qualities DCVax has already (more holistic immune response, more effective, more personalized, less toxic, more preventative, and better outcomes), it will also save our healthcare systems and insurance companies money.
Over 2,100 doses of DCVax-L were administered during the Phase III trial and only 5 serious adverse events were possibly related to the treatment (none were classed as life threatening (Grade-4) or lead to Death (Grade-5). This is unprecedented and strongly suggests that supportive care costs will be substantially lower. Not to mention palliative care costs will be reduced as more patients are cured!