Pay for residual disease tests only inside a trial or registry
Leftover-cancer blood tests are being sold faster than evidence that acting on them helps. Paying for them only when the result is recorded would generate the missing evidence.
MRD testing is spreading through routine care ahead of randomised evidence that intervention on a positive result improves survival. Coverage with evidence development — reimbursement conditional on enrolment in a registry or trial with mandatory outcome submission — turns uncontrolled adoption into a data-generating engine, as it has for some devices and PET indications.
- Dormant cells and minimal residual disease · After a 'successful' treatment, cells can sleep for years then relapse. We can barely detect them and cannot target them.
- Weak real-world evidence and registries · We do not reliably know what happens to patients after approval, so we cannot tell which drugs deliver in practice.
- Incentives reward me-too drugs and marginal gains · The system pays the same for a drug that adds two months as for a cure, so companies race to copy rather than to cure.
Pages like this
not linked directly; found by shared links- IdeaAutomatic weekly linkage of cancer registries to deaths, prescriptions and imaging
Shares SEER (Surveillance, Epidemiology, and End Results), Weak real-world evidence and registries, Real-world evidence.
- IdeaRandomise inside the registry that already follows every patient
Shares SEER (Surveillance, Epidemiology, and End Results), ClinicalTrials.gov, Weak real-world evidence and registries, Real-world evidence.
- IdeaEmulate the trial in real-world data first to decide which trials to run
Shares SEER (Surveillance, Epidemiology, and End Results), Weak real-world evidence and registries, Real-world evidence.
- IdeaReassess cancer drug prices at three years using real-world outcomes
Shares Weak real-world evidence and registries, Real-world evidence, Incentives reward me-too drugs and marginal gains.
- IdeaRandomise inside the cancer registry: registry-based trials for everyday questions
Shares SEER (Surveillance, Epidemiology, and End Results), Weak real-world evidence and registries, Real-world evidence.
- IdeaA $50 million prize for the first off-patent drug proven to extend cancer survival
Shares ClinicalTrials.gov, Incentives reward me-too drugs and marginal gains.
- IdeaRecord and publish the symptom-to-diagnosis interval for every cancer, by hospital
Shares SEER (Surveillance, Epidemiology, and End Results), Weak real-world evidence and registries.
- IdeaMandatory interval-cancer audit for every blood-based screening test
Shares SEER (Surveillance, Epidemiology, and End Results), Weak real-world evidence and registries, Real-world evidence.