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Annual Cost of Running Huntsman Cancer institute

 

A research labratory at Huntsman Cancer Institute

 

Jon Huntsman, Sr. has frequently said it costs about $120 million a year to keep Huntsman Cancer Institute going. That’s a lot of money. You could buy two rockets from SpaceX for that price. Why is it so much?

As it turns out, research is expensive.

It’s difficult to say that studies cost a certain amount of money, on average. Not all studies release their costs publicly. Even if they did, there are many different kinds of research, which cost wildly different amounts of money to complete. It’s apples and oranges. Some can take as little as a few thousand dollars, while some can cost millions.

One way to begin to understand this is by looking at potential costs. When doing this, it’s easy to see how the numbers might add up.

 

Individual Costs

Everyone working on a study needs to be paid, of course.

Rotary evaporator
A rotary evaporator

Then you have supplies and equipment.

A simple centrifuge, a small machine used to spin biological samples until the sample’s contents separate based upon density, can cost $2,000.

When performing chemical reactions, mixing two chemicals in order to react them with one another is often performed in a third chemical called a solvent. Solvents often help induce the reaction. Because a solvent is neither a starting material or a product of the reaction, it needs to be removed at some point. This is often done with a machine called a rotary evaporator, which can run up to $10,000 in some cases.  

 

Single grain of pollen under scanning electron microscope
Photo of a single grain of plant pollen, taken by a scanning electron   microscope

If a researcher has done a series of chemical reactions in order to create a specific chemical (say, in an attempt to create a new drug), they need to analyze the purity of the products they made. This is usually done with two machines called infrared (IR) and nuclear magnetic resonance (NMR) spectrometers. An IR instrument can cost about $15,000. The standard model of the NMR instrument costs about $800,000.

These are just your typical machines—and the basic versions. If a lab needs a more sensitive NMR spectrometer, it will cost them $5,000,000.

Need to know the order of As, Ts, Cs, and Gs in a gene? That machine can cost $700,000. Scanning electron microscopes allow scientists to look at the outside surfaces of objects as small as 50 nm—340 times smaller than the diameter of a strand of hair. The price tag for a new one is pushing $1,000,000.

These are far from the only machines a lab may need.

Labs also need supplies, things you can only use once: chemicals, glass slides, gloves. The list goes on and on.

Between salaries, machines, and supplies, prices can really rack up.

Another good way to visualize the cost of research is to consider as an example the cost of developing a new drug, information which is easier to come by than the cost of a single study.

 

Drug Development

Drug development timeline

To even develop a chemical that could one day become a health care treatment, basic research is done. Its purpose is to understand how a given disease works, and exactly what parts of the body need to be targeted with drugs to fix it. Only then can a chemical be made to try to stop a disease, in a process the science world calls ‘drug discovery’.

Individual laboratories all over the world might be simultaneously in the process of drug discovery for a single health issue. Based on previously published research and the work of biological chemists, they start out with an idea of what general shape a molecule might need to be or a few of the atoms it might need to contain to have the desired effect. Each lab will create what's called a library of molecules—similar chemical molecules which might have the desired effects. Then they test the chemicals in lab-grown cells, outside a living organism, to see if they affect the cells the right way.

At this stage, there might be between 10,000 and 20,000 different molecules being tested to see if they could one day become a drug for a single health issue.

If a chemical seems to work in lab-grown cells, it will be tested in animals. Usually between 5 and 20 of the original molecules will reach this stage of drug development. Researchers want to see if it works better when ingested or injected. They’ll also try to see if it travels through the blood to the proper part of the body to do its job, if it’s effective in the body, and to see whether it’s toxic or acts in unexpected ways. By this point, it’s been about 4 years since the molecules were originally isolated as possible drugs.

Next comes clinical trials, where the potential drugs are tested in humans.

Phase I clinical trials are first. The molecules are usually tested in about 50 healthy people, but sometimes on patients — like cancer patients — who have no other options. Huntsman Cancer Institute does offer Phase I clinical trials to patients upon doctor recommendation. The animal trials reduced the number of molecules still being tested to between 2 and 5, which are tested in phase I trials for about 3 years. At this stage, researchers and doctors determine how much and how often the potential drug should be administered, whether it’s having toxic effects in humans, and how it should be administered. 

 

 

 

Gleevec box.jpg

Usually, 2 potential drugs make it to Phase II clinical trials. These trials involve about 250 patients, and are used to note side effects and see exactly how effective each molecule is as a treatment. If its effectiveness doesn’t outweigh its side effects, it will be eliminated as a possible drug. By the time phase II trials are over, it’s been about 9 years since the two molecules were proposed as drugs.

If a potential drug makes it past phase II trials to phase III trials, it will be tested in about 3,000 patients for continued information about how effective it is as a treatment. By the time it’s completed, the only remaining chemical was suggested as a treatment option about 12 years earlier.

Successfully having gone through clinical trials, the last remaining molecule is subjected to FDA approval before it can be introduced into the market as a drug.

The FDA assesses benefits and risks of the potential drug, approves directions on how often it should be taken, and makes sure the drug was manufactured to be high quality—with no contamination or other such issues. Sometimes they require phase IV clinical trials, to test the drug on subgroups of patients who it may be prescribed to.

Each step in this process is a separate study for each of the individual chemicals.

All told, today the cost of developing those original 10,000 to 20,000 chemicals into a single drug is about $2.6 billion. Some drugs will later undergo additional testing to see if they are helpful for other health issues, which can bring the total to $2.9 billion for research on a single drug.

For perspective, per cancer.gov, there are currently over 200 cancer drugs in use. Drug development costs have increased exponentially over the last few decades, but if they were all made today, it would have cost over $580 billion.

 

Research at Huntsman Cancer Institute

At Huntsman Cancer Institute, there are 32 research groups involved in basic science research like the research that discovered CML’s Philadelphia chromosome, involving questions about biology, genetics, and drug discovery.

There are 25 research groups studying population data. Some of them aim to do things like improve patient outcomes and quality of life, or create genealogical databases of genetic cancers.

A final 18 research groups are involved in clinical trials or other forms of clinical research like trying to use a person’s own immune system to kill their cancer and the role inflammation plays in cancer development.

This amount and breadth of research is one of the reasons the researchers at Huntsman Cancer Institute have found more inherited genes which lead to cancer than any other cancer center in the world. They are the only cancer center in the region which does all these kinds of research simultaneously.

Given the high costs of research and the unprecedented discoveries made at Huntsman, it’s perhaps surprising it doesn’t cost more than $120 million a year to run. 


Related: 
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Accountability

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Sources:

Commissioner, Office Of the. "The Drug Development Process." U S Food and Drug Administration Home Page. Office of the Commissioner, n.d. Web. 1 May 2017. <https://www.fda.gov/forpatients/approvals/drugs/>.

Dimasi, Joseph A., Henry G. Grabowski, and Ronald W. Hansen. "Innovation in the pharmaceutical industry: New estimates of R&D costs." Journal of Health Economics 47 (2016): 20-33. Web.

"Molecules to Medicines." National Institutes of Health. U.S. Department of Health and Human Services, 27 Oct. 2011. Web. 1 May 2017.

Sebahar, Holly L. "Drug Discovery." Drug Discovery Experiment Lecture. University of Utah, Salt Lake City. 2 Mar. 2017. Lecture.

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