When you analyze the question “what is a stroke?”, you come up with the answer “it’s a heart attack in your head”. They are the same thing, affecting different parts of your body. Because of this similarity, I thought that this recent study was interesting…

For years and years, cancer drug development lagged behind drugs for cardiovascular diseases. When you look at the number of new drugs under development, though, cancer drugs are now outweighing heart disease drugs by a ratio of 700:147 (new cancer drugs in the pipeline versus new heart disease drugs).

Over the past, new heart drugs were introduced at a rate of 52:11 over cancer drugs (in the 1980’s) and in the 1990’s it changed to 74:38. Year to date, the ratio for cardiovascular to cancer has reversed to 3:13.

The driving force behind this change is, of course, money. There is more money in cancer drugs mostly because they tend to be very specialized, versus very general in the cardiovascular arena. But this is what I found most interesting: The rate of “successful development of new cancer drugs outweigh cardiovascular drugs is 7% versus 3%”. This puzzled me, but in this Tuft’s University Study they explained that the bar for acceptability in cancer drugs (meaning unwanted side-effects) was much higher. We are willing to accept far greater risk in cancer drugs than we are with heart drugs. Even the FDA is in on the act, and they approve these drugs accordingly.

Counter-intuitively, the success rate for development of cancer drugs is much lower than heart drugs (1.3-1.8% for cancer versus 4.9% for heart) but, because these drugs tend to target a smaller, more specific audience, they can garner higher prices and less (if any) competition. So the drug manufacturers and researchers have switched gears to go where the money is (even though heart disease affects more people, there is much more competition with treatment, and consequently lower prices).

I don’t know what this holds out for the long term – we are still a ways off from declaring “victory” over heart disease and stroke. But I guess they’ve held the limelight long enough.