1. Three Aces In the Hole A. James Moser, M.D.
Co- Director, BIDMC Pancreas and Liver Institute
Beth Israel Deaconess Medical Center
Associate Professor of Surgery
Harvard Medical School

2. The DDNC Mission: Three Aces
Mission: “to improve access to and
the quality of life of digestive health care…”
U.S. Mortality Statistics
#1: Heart Disease
#2: Cancer: Moser
#12: Chronic liver disease: Robson A cure for hepatitis C!
#1: Inpatient GI diagnosis
Pancreatitis: Freedman
>240,000 patients annually
$2.8 billion

3. Facts About Pancreatic Cancer
Fourth leading cause of cancer death in 2014
46,420 Americans annually
Disproportionate incidence among African-Americans
The “silent killer”: symptoms occur too late
No early diagnostic tests
No meaningful progress

4. No Time to Be Complacent
Rising incidence
Disproportionate impact on African-Americans
Surpassing breast and colon cancer by 2020

5. Crossroads of Triumph and Tragedy
Geniuses lost to pancreatic cancer
46,420 Americans beg you to succeed this year
John von Neumann
Sally Ride
Jack Kemp
Luciano Pavarotti
Jack Benny
Count Basie
William Saffire
Joan Crawford
Rex Harrison
Donna Reed
Werner von Braun

6. Perceived Value of Current Treatment: Panic!
June 9!
Brief history of
too little, too late
5- FU; 1974
Gemcitabine; 1996 (+ 1 mo)
Erlotinib; 2005 (+13 days)
Nab-paclitaxel; 2013 (+2.8 mo.)
Steve Jobs
unveiling iPhone on June 9, 2008
Lost shareholder value=
$15.95B in 3 days=
132X Annual Funding!

7. “Surgery is the only potential cure for pancreatic cancer. ”
“Surgery is the only potential cure for pancreatic cancer.” see footnote
Footnote: Except for all patients with metastases and those in whom resection cannot be done or results in a margin of less than one millimeter.

8. Current Perception: Majority Vote with Their Feet!
“Surgery is something you do, not something you have.” Anonymous
Bilimoria K, National Failure to Operate on Early Stage Pancreatic Cancer, Ann Surg 2007 Aug

9. “Human beings, left to their own devices, will usually find solutions to problems, but only if they are allowed to.” Stephen Davies

10. We Must Stop Progress!?
“The Kaiser Family Foundation study concluded that the only measures that are likely to control health care inflation over the long term are either the delay or prevention of new medical technology.” Press release Feb 2010

11. “Health Care Investment: The Hidden Crisis”
Milken WSJ Feb 8, 2011
Murphy and Topol, University of Chicago, 2006
Improvements in health care added $3.2T per year to US GDP since 1970
1% reduction in cancer death: $500B per year

12. Economic Threats to ProgressX X X
X=Recent casualties of “reform” and increased US taxation

13. Technology is Not the Problem… Monopoly and Regulation Are
Dr. Jeff Flier, Wall Street Journal, Nov. 19, 2009
Regulated marketplace
Absence of price transparency
Cost overruns
Price controls and rationing
SGR “formulas,”
Access “issues”
Workforce “targets”
Looming threats
Elective healthcare may soon follow the rest of US industry offshore

14. “We would accomplish many more things if we did not think of them as impossible.” Vince Lombardi