$107 Billion on Cancer Drugs

I did not make up that number. That is how much was spent on cancer drugs world wide last year. Is it really worth it? Does it sound normal to take a drug that costs $10,000 per month? And that $107 billion reflects a 11.5% surge from new drugs introduced last year.

A recent study was done for the National Institute for Health revealed a lot of questions, not a lot of answers. And the real question is are cancer patients getting their money's worth. The main goal of any cancer drug should be a longer life - which would be a cure. Correct me if I am wrong, but that is how I see it. Why else would we want these drugs? Its nice when they reduce pain and make us feel better as well but we really hope that we will live longer.

"The report from IMS Institute for Healthcare Informatics highlights 70 new cancer treatments, treating more than 20 types of tumors, all approved in the past five years. In the United States, where cancer drug spending was $37.8 billion last year, those new drugs alone account for $9.4 billion of the increase since 2010.""

"... Not all approved cancer drugs are alike. Some may provide profound benefits, lengthening life by years; others may significantly shrink a tumor, but increase patients' chances of survival only by small amounts.

Prasad's work has found that the high prices of new cancer drugs don't reliably reflect their novelty or how well they worked in trials. One of his studies, published last year in JAMA Internal Medicine, examined 36 drugs that were approved between 2008 and 2012 based on early indicators that they were working, such as evidence that they shrank tumors. Such measures are meant to speed up drug approvals, but there's no guarantee that a drug that temporarily stops a tumor from growing will extend lives. Only five of the 36 drugs in his study lengthened patients' lives, despite a median of more than four years of follow-up study."

So why are we spending all this money if most of them don't make us live longer? That's not worth $107 billion.

Breast Cancer: At What Cost?

Even with insurance the cost of any ailment, not matter how large or small, can be formidable. For some people the $20 co-pay to see the doctor can be a dent in their wallet. And new research shows that even with insurance, depending on coverage, state of disease at diagnosis, treatment required, and many other variables, medical bills can range between $20,000 and $100,000.
now
I know that even with my health insurance, which is pretty darn good, we spent thousands of dollars on my health right after diagnosis. And with my oh-so-healthy-body, we continue to spend thousands. And you can subtract any potential salary I might have - because I can no longer work.

Going back to work after breast cancer can take a few years. I know many women who do not return to work full time because they do not feel physically or emotionally up to it. Even if there is a financial need.

Breast, or other type, cancer diagnosis, knocks your socks off. You may never regroup. You certainly never go back to your old self (just that fictitious new normal). And that you forked out up to $100,000 just to get to that new 'normal', your wallet (and retirement) won't be the same.

You can go to doctors and medical professionals to heal physically. You can go to support group and therapists to help mentally. But financially you are never the same, no matter how rich or poor you were to stop.

You can't put a dollar value on life

The latest news out of the pharma industry is that they want to put a dollar value on a month of life. I do not think this is possible. But they want to so they can continue to justify their high priced medications.

I think many people when faced with the knowledge their life is about to be cut short would do anything or pay any price to be able to stick around longer. I am sure I would, unless I was in horrible pain or had no quality of life.

To start with how would you figure out the monetary value of life, or a month of life even? You can look at the basic necessities - food and shelter - or lost salary, or medical costs to keep someone alive. But what would that mean? I just don't understand this concept.

And to try to pull a number out of thin air to justify the cost of a medication is nonsensical.

Logical pricing comes from cost to design and create and throw in some supply and demand. And the pharma industry's way of a putting development costs from multiple drugs that didn't work out in to the development costs from a new drug and pulling a number out of a hat for perceived value for the basis of pricing, doesn't really work. And always end up in their favor.

I could never put a value on my life. Its not something that came with a number on it. So let's not try to create something that doesn't exist.

Heck yeah

Are we ready for pharmaceutical company price wars? Heck yeah! There has been a lot of 'hoohah' going on pricing with pharmaceutical companies, especially for Gilead's hepatitis C drugs which came in at a shocking $84,000 per treatment course. Which was later upped to $90K plus for second treatment option.

Now Merck has stepped into the hep C market with a new drug which is only a paltry $54,600 treatment for a 12 week course of treatment. Wowza!!! That's so much more affordable.

Of course Gilead says Merck's treatment isn't as good (of course). [And their CEO just stepped down because of the pricing crisis.] But the stock analysts are rooting for Merck on this one so we will just have to wait and see who wins this one.

But maybe instead of focusing on the big companies we should talk about the benefits to the patients. But the big news:

"One industry consultant, Roger Longman of Read Endpoints, a research firm that tracks reimbursement issues, believes that Merck’s pricing may be sufficiently tempting for benefits managers. That’s because its new treatment carries a lower list price than the Harvoni list prices, regardless of whether patients take that treatment for eight or 12 weeks, depending upon their strain of the virus.

“Essentially, what Merck has done is undercut Harvoni” in most patient populations, he explained. “And remember that Merck will also offer rebates. So they’re giving themselves some room to make it still more attractive for pharmacy benefits managers, some of which may have contracts that allow them to switch drugs if there’s a dramatic price difference from a new product.”"

So maybe there is hope for the patients after all.

Who will pay for personalized medicine?

Inventors have faced this problem for centuries: just because you can make it, does it mean anyone will pay for it? And just because its possible, doesn't mean anyone wants it. Unless you can put some guarantee of a good result on it.

Personalized and precision medicine has been the buzz for several years now. But who is going to pay for it? I have never seen this discussed previously. I sort of assumed that someone would but never thought the process through. And what happens if the test result isn't a good one?

I just know I wouldn't be happy to shell out a few thousand without the guarantee that the results would lead me to a life saving recommendation. And what if I did spend the big bucks and all the result told me was that there were no good treatment protocols for me? That would not leave me a very happy camper at all.

Back to personalized medicine... What if no one wants to pay for it? And is there a guarantee that the test results would lead to the right treatment? What if there is no good treatment protocol available?

Right now we get an ailment and start a treatment protocol. If it doesn't work, we go on to plan B, or C, or D.... all the way to plan Z. Personalized medicine is supposed to tell us skip plan A and go directly to plan L as that is right for you. But what if there is no plan L yet? Or plan L only has a 50% chance of working for you? And plans A, B and C had a 30% chance of working for you.

One test for patients with a certain type of lung cancer has now been approved for payment by one insurance company. That's a very small start. Medicare has not decided if they will pay or not.

"Medicare and private insurers have been slow to embrace genetic tests such as Foundation Medicine’s that look at a broad array of genes. (Other genetic tests, such as those that analyze specific genes known to increase a person’s risk of cancer, are more widely covered.) The payers are concerned that the tests could lead to care that won’t improve patient outcomes."
I am right there with the insurance companies (how unlike me) on this one. I want a treatment that will improve my outcome... That's the whole point of personalized medicine.

Advertising medications

Currently the AMA wants the US government to stop allowing manufacturers to advertise prescription medications and medical devices directly to consumers. Why? Because it makes patients ask for unnecessary medications. And those advertising campaigns aren't cheap - they cost millions - adding unnecessary amounts to the industry.

The FDA allowed this kind of advertising starting in 1997. The first ad for a prescription medication was in 1983 and was pulled after a few days.

The US and New Zealand are the only countries which allow this kind of advertising. Personally I wouldn't mind reading a magazine which was not full of pages of fine print of disclosures of side effects and watching TV without commercials with the soft voice over of potential issues.

I think its a complete waste of money for all these ads. If you see a medication advertised, you have no way of knowing if it will work for you or is really needed even if you have that condition. I just ignore those ads anyway and would be happy never to see one again.