Here's my opinion... maybe I am wrong. I am a man, so it wouldn't be the first time. LOLOL... I truly believe the drs "throw" a predetermined generic dose at every one of us with cml. This dose is determined by the drug manufacture who profits off selling a higher volume of meds. Yes, some people need 100mg of a drug while others may do just as well on 25mg of the same drug. I cannot wrap my head around why a dr won't try a lower dose to see how you respond. I have "self medicated" for almost 4 years now. I did go too low at one time and became detectable again. I upped my dose and was undetectable within 60 days. I then cut my dose in half and have been undetectable since then. I am in no way giving medical advice... I'm only sharing my experience with my individual case. In a nut shell I am saying that we are mostly PROBABLY over medicated. Most of us would probably benefit well from less poison in our systems.
Drug dose is determined through clinical trials. They graph response rates/patient numbers vs. dose and toxicity. The highest dose that can be "safely" tolerated for the maximum number of patients is determined through these studies, then various dose levels are examined. The dose that gives the best response without killing the patient is what becomes the standard dose
What they don't tell you is that within these studies, sub-populations of participants respond better or worse than the standard dose. A patient given 50 mg of Drug "A" will respond just as well as a patient given 100mg of the same drug - even though most of the patients in that cohort did not respond as well. In other words, the researchers already know that one size does not fit all - but it's simpler to prescribe one dose than try and figure out what is ideal on patient by patient basis.
It is not correct that drug companies push higher amount of drug in order to make more money. It doesn't work that way. The cost of manufacturing a Sprycel "pill" regardless of amount of drug in each pill is pennies per pill. It's not true, for example, that Gleevec 400mg is twice the price of Gleevec 200mg. They are about the same price. They charge what they can because they can.
Below is a link to an interesting article on what it costs to invent a new drug from concept through clinical trial and approval:
Upwards of a Billion dollars can be spent to produce a new cancer drug. Typically $100 million is spent. And that includes "dry holes" - spending money on a drug that proves to be too toxic for human use or is proven not to work.
I have no affection for drug companies. Their profits are insane - but in our capital intensive system, I don't see a better way other than "greed" to drive the mother of invention. Take away the incentive for these companies to develop these drugs and innovation is likely to stop. There is a reason why the U.S. with only 5% of the worlds population is the number one economy.
The key, I believe, lies in fostering competition in some way so more than one drug company is going after the same set of "customers". In this way, the answer lies in reforming the clinical trial process (not the science, but the bureaucracy) in order to reduce cost. Reform the patent laws so instead of a 20 year exclusion, maybe it's 10 years following drug approval or some other time period so that more competition can be brought to bear sooner. And the answer lies in public-private partnerships. Many of the drugs "invention" occur in labs associated with public universities. In the same way that the government created the interstate highway system, and - yes - the Internet (Al Gore reprise), government (that means "we the people") funds lot of basis research that leads to these great drug breakthroughs. The public should share, in some way, the ultimate profit derived from a successful implementation of the research. Some of that does happen, but not enough.
Reducing drug cost, in one way or another, will necessarily involve increasing supply, increasing competition and decreasing cost of the clinical trial process. Another way is to reduce demand - but that is not practical since no one I know elects to get cancer.
Diagnosed 11 May 2011 (100% FiSH, 155% PCR)
with b2a2 BCR-ABL fusion transcript coding for the 210kDa BCR-ABL protein
Sprycel: 20 mg per day - taken at lights out with Quercetin and/or Magnesium Taurate
6-8 grams Curcumin C3 complex.
2015 PCR: < 0.01% (M.D. Anderson scale)
2016 PCR: < 0.01% (M.D. Anderson scale)
March 2017 PCR: 0.01% (M.D. Anderson scale)
June 2017 PCR: "undetected"
September 2017 PCR: "undetected"