Hi Zeke, I would have liked to do a more detailed analysis of impact, but QALY/WALYs are not my expertise, and I would have made many mistakes. This analysis would be very valuable, both for the narrow scope (Crohn’s disease), and the full potential scope of the project (the other diseases shown in bold). Crohn’s affects young adults for life. Total worldwide prevalence is not know precisely due to poor monitoring in many countries. Many studies report Crohn’s and ulcerative colitis prevalence combined.
“A cheap cure for Crohn’s could save some large fraction of the $33B spent on Crohn’s per year, and these funds could save thousands of lives per year if spent on other diseases.”
Hi Zeke, I would have liked to do a more detailed analysis of impact, but QALY/WALYs are not my expertise, and I would have made many mistakes. This analysis would be very valuable, both for the narrow scope (Crohn’s disease), and the full potential scope of the project (the other diseases shown in bold). Crohn’s affects young adults for life. Total worldwide prevalence is not know precisely due to poor monitoring in many countries. Many studies report Crohn’s and ulcerative colitis prevalence combined.
Going from moderate disease to remission seems to be an increase of about 0.25 QALY/year (https://academic.oup.com/ecco-jcc/article-pdf/9/12/1138/984265/jjv167.pdf). If this research accelerates treatment for sufferers by an average of 10 years then that’s an impact of 5 million QALY.
Crohn’s also costs $33B per year in the US + major European countries (https://www.ncbi.nlm.nih.gov/pubmed/25258034). If we convert that at a typical Western cost-per-statistical-life-saved of $7M, and the average life saved is +25 QALY, that’s another 1.2 million. Maybe 2 million worldwide because Crohn’s is mostly a Western phenomenon (https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)32448-0/fulltext?code=lancet-site). So that’s 7 million QALY overall. Which of course we discount by whatever the probability of failure is.
It’s very rough but it’s a step forward, don’t let the perfect be the enemy of the good.
33000⁄7 * 25 is 120k not 1.2M.
I know. It’s ten years of savings, because curing is accelerated by ten years.
Hi Zeke, Thank you very much for the detailed analysis! Wow, great work!
What phrase should we place in the summary?:
“Crohn’s is estimated to cost 33B$/year in developed countries, and a cure would represent approximately ? QALY.”
“A cheap cure for Crohn’s could save some large fraction of the $33B spent on Crohn’s per year, and these funds could save thousands of lives per year if spent on other diseases.”
Thanks, very much appreciated! I will ask Mati to change the summary.