Impact of Cancer Research Bureaucracy on Innovation, Costs, and Patient Care

Abstract

Batteredworkshoptablesandcrowdedchemicalbenchesbearsilentwitnesstothe thousands of failed prototypes that preceded development of theincandescentlightbulb,waxcylinderphonograph,andothertechni-cal advances described in Edison’s record 1,093 US patents. Edisonoftenwentseveraldayswithoutsleepingandmighthaveworkedevenlonger hours than a 1960s medical house officer. He so detestedstoppingworktowaitforsuppliesfromvendorsthathekeptbinsandcupboards stocked with a broad range of exotic materials—anythinghisresearchteamsmightpossiblyneed.If Edison were an American cancer investigator working in theearly21stcentury,delaysinthesupplychainwouldbetheleastofhisperspiration-inducing problems. His shirt might be soaked withsweat, but his productivity would likely be meager and his nameunknown at the patent office. Today, the inspirational idealism ofnewly minted medical faculty members with a driving ambition to“cure cancer”—oncology’s Edisons—is being smothered under amountain of red tape, their good intentions crushed by the logisticalrealityofwhatitactuallytakestoopenandexecuteaclinicalstudy.Trials of new drugs, especially in oncology, have become a longrow to hoe.