In this episode, EconTalk host Russ Roberts returns to a common theme- the treatment of cancer. With author and oncologist Vinay Prasad, Roberts explores why today’s cancer drugs cost too much and deliver too little, even when we consider some exceptionally successful drugs. Should we think of cancer treatment drugs in terms of value propositions? How can we put a dollar figure on the addition of one good year of life?

Consider the prompts below to help further your thinking about this episode. Even better, use them to start a #conversation offline, and let us know how it goes. You can always reach us as We love to hear from you.



1- Roberts credits Prasad for his awareness of trade-offs in cancer medicine. Prasad says,  “…what we’re doing in medicine is not paying for these low value practices: We are actively not paying for higher value practices.” What does he mean by this, and how does it frame his entire project?


2- Roberts and Prasad agree that the patent system is not the problem. Why not? To what extent are you convinced by this argument?


3- How are US taxpayers funding drugs for people around the world, according to Prasad? And why does he argue that  “the premium we’re paying in the United States, is more than enough to sustain all of the innovation globally?”


4- If the goal isn’t to make drugs that are good for cancer patients, what is the goal?


5- Prasad regards his work as a call to arms to consider reform. What are some of the reforms he suggests, and how much potential do you think they have? What other reform ideas can you suggest to combat some of the problems discussed in this episode?