Fate of Accelerated Approval

I discuss our new JAMA Oncology paper here:
The Oncologic Drugs Advisory Committee Votes of April 2021-Implications for the Fate of Accelerated Approval
jamanetwork.com/journals/jama...
Vinay Prasad, MD MPH
HemeOnc Doctor & Associate Professor of Epi/ Biostats
Host of Plenary Session Podcast
/ plenarysession
Twitter @vprasadmdmph

[@DrBrandonBeaber]

Nice video. I look forward to your commentary on aducanumab

[@sgeorg80]

👍

[@Geroscientist]

Well said @ 9:05 "...impoverished and hurting are the average american people...paying for this healthcare that we frankly don't know make us any better"
This is a more meta take on medicine, and in part from a basic science perspective (which VP may not like), but the disease-specific strategy never made much sense in the 1st place for age-related dz. The Taeuber Paradox implies how trying to cure 1 disease at a time fails to account for competing risks of comorbidities: if we cure cancer or CVD, each would add only 2.5 years to life expectancy, as Gompertzian doubling time applies to all age-related diseases.
E.g. the prevalence of Alz Dz has likely increased *because* people live longer from successes in delayed CVD. The question we should be asking is: we are living longer - but are we really living healthier?
The Physician JF Fries advanced the concept of 'compression of morbidity' as a goal of medicine, to maximise the proportion of life spent in good health; unfortunately, this has clearly not occurred despite our best efforts. Instead, such as argued in Crimmins, 2015 "Lifespan and Healthspan: Past, Present, and Promise", only by slowing aging can we delay the onset of all age-related diseases and improve *healthspan*. This thinking is missing in medicine, though not (yet) having any clinical data to support it doesn't help. If we look to epidemiology and consider how the greatest risk factor for disease - age - underlies all the major causes of suffering/mortality, yet has been ignored until recent years in translational research, we may be missing something critical.