Press Release:
For immediate release
Tuesday, May 16, 2006
12:01 a.m. EDT


Christopher Fleming

Expensive Biotech Drugs Are Worth It,
Says Caltech President Baltimore

Bethesda, MD -- Is it worth paying for biotechnology products that carry large price tags and benefit relatively small groups of patients? It is according to David Baltimore, the biotech pioneer and retiring president of the California Institute of Technology.

 “The people who do benefit, benefit enormously,” Baltimore says in an interview published May 16 as a Health Affairs Web Exclusive. His answer might be different if he “were in an underdeveloped country where resources were a very limiting factor,” Baltimore tells Health Affairs deputy editor Barbara Culliton. But “we’re in a highly developed country where it’s a matter of, ‘Do you spend the money to keep a few people alive, or do you spend the money on something crazy like the war in Iraq?’”

Some physicians are able to distinguish the patients who might benefit from a particular treatment by providing the appropriate test; for example, Culliton notes that physicians generally give tamoxifen as therapy only to breast cancer patients with estrogen-senstive tumors. But, as Baltimore points out, tests necessary to stratify patients by their tumors’ genetic profiles are   still not readily available for some important newer medications, such as another class of cancer treatments that includes Erbitux, Tarceva, and Iressa.

“We thought that there was going to be a simple formula” for the use of these drugs, “but it’s not so simple,” Baltimore says. “In any case, it will take a really serious clinical trial before we can stratify patients. So meanwhile, lots of people are taking the drugs, and a small but real number are benefiting.”

Inexorable Biomedical Progress And Genomics Revolution
Will Necessitate Universal Coverage

Baltimore’s conversation with Culliton represents the third in a series of Health Affairs interviews with leaders in biomedical innovation, which is sponsored by the nonprofit Institute for Health Technology Studies (InHealth). The CalTech president calls generating a dialogue between the biomedical and health policy communities an “excellent idea.” He says that the two communities should discuss “how the medical health care establishment will adapt itself to changing circumstances and how all of this will be affordable, because the industry’s going to produce more and more opportunity at higher and higher prices. And I’m worried that sooner or later we will run into issues about the ability to pay.”

Baltimore argues for universal health insurance, which he asserts will become a necessity as genetic research progresses. “The genomics revolution … is making it clear that we are all genetically hamstrung in one way or another. And the only way to treat people who have genetic diseases, and we all do, is to think about universal coverage. We can’t hold individuals responsible for their genetics.”

Baltimore, who is the new president of the American Association for the Advancement of Science, also tackles the subject of education. He worries that too many American children will be consigned to low-paying jobs by the lack of a good science education. While many observers who express the same concern locate the problem in the American K-12 educational system, Baltimore stresses the role of parents. “I see kids at Caltech who clearly have been raised by parents who cared enormously about education,” he says.

Culliton asks: “Do you think there’s a way to make more parents like those?” Baltimore, who heads a school that is about 30 percent Asian American, answers: “It’s pretty hard. It’s cultural. We import a lot of the best parents.”

You can find the interview at


Health Affairs, published by Project HOPE, is the leading journal of health policy. The peer-reviewed journal appears bimonthly in print with additional online-only papers published weekly as Health Affairs Web Exclusives at


©2006 Project HOPE–The People-to-People Health Foundation, Inc.