Team:UNSW Australia/Cancer


Team: UNSW Australia


Cancer

Overview

Through thinking carefully and creatively about cancer in Australia, we were able to undercover the size and effect that it had on the community showing it was a real problem that needed to be solved. Through engaging with Dr Peter Gunning and the PBS we were directed to improving Paclitaxel manufacturing in an attempt to free up government budget allowing for improvement of overall cancer treatment. During this process, we learnt the importance of understanding the underlying mechanisms of the problem, in this case, the PBS pricing mechanism. Through this understanding, we ensured that applying Assemblase to Paclitaxel manufacturing would be implemented by all manufacturers having a successful impact in reducing the cost pressure in cancer treatment.

Consideration

In our investigation of cancer, we looked at the cost to the community, how many people are affected and common cancers. From these considerations we further explored potential problems within treatment. We did further research to explore Paclitaxel is a widely used drug with vast inefficiencies in its manufacturing process leading to high cost of treatment. Our key considerations are as follows:

  • In Australians 431,7041 are living with cancer costing $6.3 Billion2 with $1.8 Billion paid out of pocket
  • Breast cancer accounts for $0.8 Billion3 of that amount with 19,5354 yearly diagnosis and 3,185 yearly deaths
  • Paclitaxel is a commonly used anticancer drug with expensive treatment costs of $800 per month5 due to an inefficient manufacturing process

Engagement

To validate our initial considerations, we consulted with the Chair of the NSW Cancer Institute Cancer Research Advisory Committee Dr Peter Gunning. Dr Gunning stated, “70% of chemo patients will require the use of Paclitaxel at least once throughout their treatment process.” This showed us the importance of pursuing Paclitaxel manufacturing to improve breast cancer as well as, overall cancer therapy in Australia.

Our next engagement to was consulting the Australian Federal Government’s Pharmaceutical Benefit Scheme (PBS) to confirm our initial research on Paclitaxel. Through our discussion with the PBS our initial thoughts on Paclitaxel were incorrect with Manaf Al-Momani suggesting, “It can be seen that the price of Paclitaxel has significantly dropped mainly due to price disclosure.” Paclitaxel is not an expensive drug to manufacture in Australian costing $24.836 per dose. Despite this discovery, we realised that even a reduction in price by $1 would still amount to PBS paying $500,000 less for Paclitaxel. This demonstrated that implementing Assemblase into Paclitaxel would still be commercially viable allowing better allocation of funds for cancer treatment. This also suggested to us that we would have to make further improvements in our production method to have a significant effect on the community.

Integration

Through our engagement seen above, we were able to validate our concerns as well as, the problem associated with Paclitaxel production. Considering the advice, we received it was decided to discover how we could incorporate Assemblase into Paclitaxel manufacturing with integrations summarised below:

  1. We decided to find a mechanism whereby Assemblase could be used to more efficiently produce Paclitaxel. This was done through incorporating two different pathways into the enzyme scaffold resulting in an improved and more sustainable manufacturing process outlined here .
  2. By validating Paclitaxel was a viable problem, we looked to mathematical modelling to demonstrate the increase in yield Assemblase would have on Paclitaxel production

References

  1. Cancer statistics | Cancer Australia [Internet]. Canceraustralia.gov.au. 2019 [cited 9 October 2019]. Available from: https://canceraustralia.gov.au/affected-cancer/cancer-statistics
  2. Goldsbury D, et al. Health services costs for cancer care in Australia: Estimates from the 45 and Up Study. PLOS ONE [Internet]. 2018 [cited 9 October 2019];13(7):e0201552. Available from: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0201552
  3. Whilton F. Cancer costs Australian health services over $6 billion a year: new research | Cancer Council NSW [Internet]. Cancer Council. 2019 [cited 9 October 2019]. Available from: https://www.cancercouncil.com.au/media-release/cancer-costs-australian-health-services-6-billion-year-new-research/
  4. Understanding breast cancer [Internet]. Breast Cancer Network Australia. 2019 [cited 9 October 2019]. Available from: https://www.bcna.org.au/understanding-breast-cancer/
  5. Force RW, Pugmire BA, Culbertson VL. Comparing medical cost of care for patients with metastatic breast cancer receiving taxane therapy: claims analysis. American health & drug benefits. 2010 Jul;3(4):276.
  6. Price Disclosure [Internet]. Pbs.gov.au. 2019 [cited 9 October 2019]. Available from: http://www.pbs.gov.au/info/industry/pricing/price-disclosure-spd