a. james moser, m.d. co- director, bidmc pancreas and liver institute beth israel deaconess medical...
TRANSCRIPT
A. James Moser, M.D.Co- Director, BIDMC Pancreas and Liver Institute
Beth Israel Deaconess Medical CenterAssociate Professor of Surgery
Harvard Medical School
Three Aces In the Hole
• U.S. Mortality Statistics– #1: Heart Disease– #2: Cancer: Moser– #12: Chronic liver disease: Robson
A cure for hepatitis C!• #1: Inpatient GI diagnosis
• Pancreatitis: Freedman• >240,000 patients annually• $2.8 billion
The DDNC Mission: Three AcesMission: “to improve access to and
the quality of life of digestive health care…”
Facts About Pancreatic Cancer
• Fourth leading cause of cancer death in 2014– 46,420 Americans annually
• Disproportionate incidence among African-Americans
– The “silent killer”: symptoms occur too late• No early diagnostic tests
– No meaningful progress
http://www.lshtm.ac.uk/eph/ncde/cancersurvival/http://www.lshtm.ac.uk/eph/ncde/cancersurvival/
No Time to Be Complacent
• Rising incidence• Disproportionate
impact on African-Americans
• Surpassing breast and colon cancer by 2020
Crossroads of Triumph and Tragedy
46,420 Americans beg you to succeed this year
Werner von Braun
John von NeumannSally RideJack KempLuciano PavarottiJack BennyCount BasieWilliam SaffireJoan CrawfordRex HarrisonDonna Reed
Geniuses lost to pancreatic cancer
Perceived Value of Current Treatment:
Panic!
Steve Jobs unveiling iPhone on
June 9, 2008Lost shareholder value=
$15.95B in 3 days=132X Annual Funding!
June 9!
Brief history oftoo little, too late
• 5- FU; 1974• Gemcitabine; 1996 (+ 1 mo)• Erlotinib; 2005 (+13 days)• Nab-paclitaxel; 2013 (+2.8 mo.)
“Surgery is the only potential cure
for pancreatic cancer.”see footnote
Footnote: Except for all patients with metastases and those in whom resection cannot be done or results in a margin of less than one millimeter.
Bilimoria K, National Failure to Operate on Early Stage Pancreatic Cancer, Ann Surg 2007 Aug
Current Perception:Majority Vote with Their Feet
!“Surgery is something you do, not something you have.” Anonymous
“Human beings, left to their own devices, will usually
find solutions to problems, but only if they are allowed to.”
Stephen Davies
We Must Stop Progress!?
“The Kaiser Family Foundation study concluded that the only measures that are likely to control health care inflation over the long term are either the delay or prevention of new medical technology.”
Press release Feb 2010
“Health Care Investment: The Hidden Crisis”
• Milken WSJ Feb 8, 2011• Murphy and Topol, University of Chicago, 2006
– Improvements in health care added $3.2T per year to US GDP since 1970
• 1% reduction in cancer death: $500B per year
Technology is Not the Problem…Monopoly and Regulation Are
• Dr. Jeff Flier, Wall Street Journal, Nov. 19, 2009• Regulated marketplace
– Absence of price transparency– Cost overruns
• Price controls and rationing– SGR “formulas,”– Access “issues”– Workforce “targets”
• Looming threats– Elective healthcare may soon follow the rest of US
industry offshore