$93,000 cancer drug treatment that extends lives by only 4 months...is it worth it?

[cynatnite]

Federal officials are conducting an unusual review to determine whether the government should pay for an expensive new vaccine for treating prostate cancer, rekindling debate over whether some therapies are too costly.

The Centers for Medicare & Medicaid Services, which dictate what treatments the massive federal health-insurance program for the elderly will cover, is running a "national coverage analysis" of Provenge, the first vaccine approved for treating any cancer. The treatment costs $93,000 a patient and has been shown to extend patients' lives by about four months.

Although Medicare is not supposed to take cost into consideration when making such rulings, the decision to launch a formal examination has raised concerns among cancer experts, drug companies, lawmakers, prostate cancer patients and advocacy groups.

Provenge, which was approved for advanced prostate cancer in April, is the latest in a series of new high-priced cancer treatments that appear to eke out only a few more months of life, prompting alarm about their cost.

http://www.washingtonpost.com/wp-dyn/content/article/2010/11/07/AR2010110705205.html?hpid=topnews

[ishaneferguson]

1. Death Panels

This is the kind of decision that Gov Palin says "Death Panels" make.

[DainBramaged]

25. UH QUITTER FORMER Governor Fallin

:mad:

[Ginto]

2. Probably if you're the one going to die now or 4 months later.

Raise taxes, end the wars and this can be afforded easily.

[pitohui]

42. so i should vomit for 4 extra months to enrich the greedy?

i need to see some quality of life, all i'm seeing is that a hellish existence is being extended not for benefit of the suffering patient who is begging to be allowed to die but in order to drain the family of every last penny

my friend's father begged to be allowed to die of his terminal cancer for a year, because of the hellish pain

what crime did he commit that his suffering should be extended so long other than have enough money/insurance to be worth putting in some hospital's pocket?

[Ginto]

44. They can't make you take the medication. It's each patients choice. nt

[pitohui]

47. you don't live in the real world

of course they can make you take it, it's called social pressure and family pressure, it's called somehow the doctor/hospital finds the most hysterical member of the family who calls it suicide if you don't swallow every pill and get zapped w. every bit of radiation to lean on you...it's called starting a family war by putting pressure on the person to "keep fighting" and you have to humor the family member that can't accept the reality of death (there's always one)

you're sick, you're tired, and everyone is telling you what to do, to pretend you have much choice when you're either half asleep or puking is pretty unrealistic in what i've seen

maybe YOU'LL be strong enough to stand up to social pressure while puking your guts out, most aren't

[Ginto]

56. And you don't have to give in to family pressure.

You are free to choose to live or die.

Whether it be 4 months, a year, 5 years.

[pipi_k]

59. some people might do it subconsciously, though

as I pointed out in another post...

My MIL was 93 and very, very tired, but was reluctant to "let go" because she was afraid to leave her daughter with a terribly broken heart. No pressure...just lots and lots of awful sadness.

Once everyone was able to admit that Mom was dying, things got so much easier.


In fact, one day my SIL and I took Mom's mylar balloon that she had gotten from the grandkids a nearly three weeks before...that it was still full of helium was amazing in itself...anyway, my SIL and I took it out onto the back deck and released it in a symbolic "letting go". By this time, Mom was in a coma for about a week.

The next morning she died.


People can prevent pressure from family by making sure the proper documents are available to responsible family members who can be trusted to follow them to the letter.

[pipi_k]

57. My MIL solved that little problem...

by having a "living will/DNR" made up years before she died.

During her final few months it became apparent that she was going downhill fast and did not want to be here. By "here", I mean, in this world.

Trouble was, some members of the family did not want to face that fact, and their attitudes were making it difficult for Mom to let go.

But those of us who had to care for her knew what she was going through, and when we brought out her signed document, the last ER doctor we talked to immediately placed her into hospice care in my home.

That means NO medications other than for pain or nausea.

She died about six weeks later. Peacefully. In our home.

If there is someone in the family more level-headed and reasonable than the rest, who isn't going to "force" the patient to take drugs s/he doesn't want, then that person should be given responsibility for the DNR.

And that is the "real world".

[Warren Stupidity]

87. it appears to be relatively mild and is expensive because it is

customized to your blood cells.

[uncommon]

3. Are these drugs made from the goddamn tears of angels????

It constantly baffles me how expensive some of these drugs are.

Frankly I don't think 4 months is worth $93K but I guess we should leave that up to the individual, no?

[slackmaster]

7. My boss's daughter has Williams Syndrome, which has caused numerous problems

The treatment for one hassle she went through cost $5,000 per daily injection, for a month.

[Roon]

78. Wow! And I thought my $2,300 monthly drug bill was big

Thank goodness for medicare!

[Travis_0004]

14. Drugs are expensive because of R&D cost

Developing a new drug can cost millions of dollars. Plus, a company might spend millions on drugs that never come to market. Plus, if a drug is found unsafe, they can be liable for millions of dollars.

Also, a pantent on drugs is only for 20 years, but they might file a patent long before a drug comes to market (since FDA approval takes years, so they could have 15 years or less.

The way I see it, a company can develop medicine and spend millions developing it. It sucks that it cost 100k, but if the alternative is not developing it at all, then I won't complain.

[uncommon]

23. Yes, it is better than not having the medicine, but there has to be a better way.

[tridim]

37. Not entirely true, most drugs are expensive because the profit margin is massive

Some drugs (even old ones) are marked up as much as 550,000%.

Celebrex 100 mg
Consumer price (100 tablets): $130.27
Cost of general active ingredients: $0.60
Percent markup: 21,712%

Claritin 10 mg
Consumer Price (100 tablets): $215.17
Cost of general active ingredients: $0.71
Percent markup: 30,306%

Keflex 250 mg
Consumer Price (100 tablets): $157.39
Cost of general active ingredients: $1.88
Percent markup: 8,372%

Lipitor 20 mg
Consumer Price (100 tablets): $272.37
Cost of general active ingredients: $5.80
Percent markup: 4,696%

Norvasec 10 mg
Consumer price (100 tablets): $188.29
Cost of general active ingredients: $0.14
Percent markup: 134,493%

Paxil 20 mg
Consumer price (100 tablets): $220.27
Cost of general active ingredients: $7.60
Percent markup: 2,898%

Prevacid 30 mg
Consumer price (100 tablets): $44.77
Cost of general active ingredients: $1.01
Percent markup: 34,136%

Prilosec 20 mg
Consumer price (100 tablets): $360.97
Cost of general active ingredients $0.52
Percent markup: 69,417%

Prozac 20 mg
Consumer price (100 tablets) : $247.47
Cost of general active ingredients: $0.11
Percent markup: 224,973%


Tenormin 50 mg
Consumer price (100 tablets): $104.47
Cost of general active ingredients: $0.13
Percent markup: 80,362%

Vasotec 10 mg
Consumer price (100 tablets): $102.37
Cost of general active ingredients: $0.20
Percent markup: 51,185%


Xanax 1 mg
Consumer price (100 tablets) : $136.79
Cost of general active ingredients: $0.024
Percent markup: 569,958%

Zestril 20 mg
Consumer price (100 tablets) $89.89
Cost of general active ingredients $3.20
Percent markup: 2,809%

Zithromax 600 mg
Consumer price (100 tablets): $1,482.19
Cost of general active ingredients: $18.78
Percent markup: 7,892%

Zocor 40 mg
Consumer price (100 tablets): $350.27
Cost of general active ingredients: $8.63
Percent markup: 4,059%

Zoloft 50 mg
Consumer price: $206.87
Cost of general active ingredients: $1.75
Percent markup: 11,821%

[uncommon]

40. See, this is the thing. I understand R&D is expensive - BUT

for some of these, the use is so widespread that you just cannot tell me that the R&D costs haven't been covered for a very long time. It's greed pure and simple on a lot of this stuff.

[pitohui]

45. tridim now don't put these facts out there to interfere with astroturfer's industry propaganda!

simple common sense should tell anyone that when even gold is a mere $1,400 an ounce that a random chemical is not worth the prices being charged but people keep repeating these harmful lies about why somehow, some kind of way, drugs should costs thousands...it just disgusts me...why do people hate themselves and their families and want to argue in favor of the very few taking all the money?

[jancantor]

86. it's not the cost of the chemical.

if you spend 10 million dollars to develop a drug, but it only costs .10 per pill ONCE the drug is designed, what is the true cost of the drug?

Part of the way that is determined is by amortizing that cost over the patent life (assuming no better drug is developed by a competitor that lowers the demand for your drug), suspected rates that people will contract the disease that you are treating, etc.

there's no "fair" way to do that. On the one hand, it's insane that something that costs .10 to make costs the purchaser $50

On the other hand, what's the incentive to spend millions of dollars searching for new drugs, testing them, etc. if there is no profit motive at the end?

[JerseygirlCT]

82. I'm not entirely sure that's true

I remember reading that the drug companies actually spend more on marketing than on R&D - much of which is also supported with grants from NIH and the like.

I'll have to see if I can find the article.

[CreekDog]

4. I'm not sure, but you could do a lot in 4 months

maybe :shrug:

[pitohui]

48. you can't do a lot in 4 months puking up chemo EOM

,

[Kurt_and_Hunter]

5. Or how about $96 million and prolonging life for one week?

We know that such decisions have to be made at some point along the sliding scales of cost and utility so there can be no absolute answers.

[mkultra]

6. i think if it where me, i would just pass peacefully

i mean, does 4 more months seem worth it? I guess it depends on the circumstances. Like if i had a baby coming or something.

[Uben]

8. I would imagine.....

... it would only be worth it to the person needing it!

Would I pay $93K for four more months? You bet your patooty I would, if I had it....and I do.


The travesty is that there is a treatment that costs so damned much! Ten'll get ya twenty 75% of it is profit!

[Catherina]

9. Not from my taxes. Not in a world with so many homeless, hungry people

Of course the important question is why does this drug cost $93,000?

Executive Salaries - http://www.dailyfinance.com/company/dendreon-corporation/dndn/nas/key-executives

Dendreon Insider Trading in last 4 months

Date Name Transaction Num Shares Price(s) Value
10/18/10 FROHLICH MARK W Sold 2,855 $37.68 107,565.27
09/17/10 HAMM RICHARD F JR Exercise 7,948 $4.66 36,997.94
09/16/10 HAMM RICHARD F JR Sold 25,828 $49.28 1.27 Mil
09/10/10 URDAL DAVID L Sold 4,000 $41.61 166,440.00
09/09/10 URDAL DAVID L Sold 32,369 $41.46 1.34 Mil
09/03/10 URDAL DAVID L Sold 10,000 $40.50 405,000.00
08/30/10 URDAL DAVID L Sold 7,369 $36.45 268,587.53
08/25/10 URDAL DAVID L Sold 7,369 $35.93 264,780.69
08/20/10 CLARK IAN THORNTON Sold 7,500 $37.46 280,967.25
08/20/10 CLARK IAN THORNTON Exercise 7,500 $26.64 199,800.00
08/04/10 FROHLICH MARK W Sold 4,283 $40.00 171,320.00
08/04/10 URDAL DAVID L Sold 40,000 $39.21 1.57 Mil
07/19/10 FROHLICH MARK W Sold 2,855 $31.42 89,704.10
07/19/10 FROHLICH MARK W* Sold 2,855 $31.42 89,704.10
07/06/10 HAMM RICHARD F JR Exercise 45,951 $5.18 237,796.42
07/01/10 SCHIFFMAN GREGORY T Exercise 40,708 $4.90 199,469.20
06/14/10 DZIURZYNSKI BOGDAN Sold 16,250 $39.05 634,593.38
06/10/10 FROHLICH MARK W Exercise 28,377 $5.20 147,560.41
06/08/10 HAMM RICHARD F JR Exercise 28,253 $4.37 123,465.61

http://moneycentral.msn.com/investor/invsub/insider/trans.asp?Symbol=DNDN

[exboyfil]

15. Without such profit potential

There is a chance many of these drugs will never exist.

I see it as self correcting once single payer monoposy comes into play for drugs. Such drugs will never be developed anymore except on special orphan set aside (which will have little political will given the number impacted versus the cost). From a societal standpoint, I think this is for the best. Yes I guess I am for Death Panels.

In many countries like Canada and Brazil if drug companies don't sell at the price that Canada demands, they threaten to break patents to ensure availability of drugs at the price the state wants to pay. I am of the firm belief that the U.S. government should never spend more for a drug than the deal any other country is getting. Our negotiators should go in with the Canada and other country drug prices in hand when they set prices for Federal and State funded drugs.

[hedgehog]

10. The question isn't how long the life is prolonged, but what kind of life

the patient lives. Are we talking four months of going about your normal business pain free, or four months shivering with fever in a hospital bed tied to monitors and catheters?

[HopeHoops]

11. Personally - if it put a financial burden on my family, I would turn it down.

I think that we as a society have an obligation to use "insurance" the way it was designed - to spread the risk. I paid into it for many years and seldom used it (certainly not to the amount that I paid in a given year). I've had some recent issues that required using it and STILL got smacked with a shitload of bills. If the teabaggers and other Republicans get their way, it will just get worse. I'd rather lose the 3 months than strap my wife and kids with the GOP chains.

[d_r]

12. depends of course

If my kids got to keep the 93K then I'd go ahead and check out early. But they'd probably want to pay the money for the 4 months.

[PatentlyDemocratic]

13. This is tailored therapy

It requires a skilled technician to manipulate a person's cells ex vivo and prepare them for reinjection. This intermediate step requires G-CSF, which is expensive to purify (e.g. one syringe is ~$3000) too. That's part of the reason why it costs so much.

That being said, it doesn't add up to $93,000.

As an aside, this sort of custom immunotherapy of cancer is what I see as the future of cancer treatment. You essentially educate your immune system to attack the cancer. It has potential to wipe out what surgery/chemo/radiation cannot.

[Lisa0825]

21. Thanks for that explanation! Very interesting! And welcome to DU! :-)

[BrklynLiberal]

36. So, this is like buying a custom made car....by your specs only...as opposed to buying a car off

the assembly line with some extra options?

[Lucy Goosey]

16. It's hard for me to have any sort of objective opinion on this

But I guess that's not stopping me from weighing in.

My Mom has been on two of these drugs, and Alimta in particular is a big part of the reason she is still alive, and living well, 3 1/2 years after a stage 3b lung cancer diagnosis - she went into remission after doing Alimta/cisplatin chemo. Alimta in advanced (but not metastatic) lung cancer cures some people, and the rest of these drugs probably do, too.

The cancer came back, but is currently on Tarceva, which has prevented the tumour from growing bigger than an olive pit for a year now. (Her original tumour, the one that went into remission, was about the size of a small apple.)

I guess what I'm saying is that writing off a whole drug based on an "average" of 4 months life extension disregards the exceptions.

And for anyone believing the right wing bullshit about "some government beaurocrat in an office" deciding it's not cost effective and denying doctor prescribed treatment - we're in Canada. Tarceva would cost $3000 a month here; Mom only pays $8 a month in dispensing fees.

[cynatnite]

24. Very compelling story and why we need to do much better in the US. n/t

[Warpy]

17. If you're going to go to a child's wedding or greet

your first grandchild in a couple of months, yeah, it's worth it.

Sometimes that month or two is vitally important, if it's an active month or two. If it's just more time in a hospital bed, nah.

[fantaztico]

18. That's a good point

It's an angle I had not thought of. I would not want to miss the wedding of my daughter, for example. I would probably seek to extend my life for that purpose, if I could afford it.

[Lisa0825]

22. Welcome to DU! nt

[stray cat]

19. how many would it have to cure to make it worthwhile?

[Change Happens]

20. NO, not at all....

[DainBramaged]

26. Every minute of breath is all you have

what cost humanity?

[leftstreet]

27. If it makes a profit for the drug company stockholders, why not?

4 months is still plenty of time to fleece a dying person for some profits!

:sarcasm:

[GaYellowDawg]

28. It sure as hell is.

My father died from cancer back in April. I would have gladly gone $93,000 into debt to have him around for four more months. Those of you who are saying no would adjust your answer very quickly if your life or the life of one of your loved ones were involved. It's almost enough to make me wish for precisely that for you.

[cynatnite]

30. We lost my dad several years ago and I'd go into debt for the extra months...

We lost him less than a month after finding out about his cancer. I was told that I should be glad he didn't suffer for very long, but I have a tough time feeling that way. I wanted him around a lot longer...he was only 48 years old. Thinking about his just rips my heart out all over again. :cry:

[d_r]

88. cynatnite

we lost my Dad when he was 60. He lived about 3 months after the diagnosis. I understand completely what you are saying. I'm so sorry to read about your loss.

[GaYellowDawg]

90. d_r and cynatite...

I think we all understand each other very well. It's just a damn shame that we do. I'm sorry for both of your losses!

[Roon]

84. Which is exactly why I have a living will and gave control to my partner

My partner knows very well that I don't want to linger when the end is near. But my mother would let me suffer until the very bitter end. Screw that!

[TorchTheWitch]

94. Sorry, but you're wrong

My father died of cancer, and the only good part of it as far as I'm concerned is that he died relatively quickly. To me, and to him, prolonged suffering was NOT preferable. As for myself, another big NO. I'd far rather die than extend a life of suffering for four more months. In fact, all my life it hasn't been death that has frightened me, it's living with suffering. I don't believe that death is the ultimate tradgedy and never have. For me, death is often a merciful release, and I would never be so selfish as to wish to deny that release to a loved one nor myself.

Losing my father was the most painful thing that ever happened to me, but I'd far rather that he passed when he did than have had him around for four more months of suffering.

[GaYellowDawg]

96. You have no right to tell me I'm wrong.

My father fought for every moment of life, and would have kept on fighting, given the option. That was always his wish. He was always willing to try new treatments, new chemo, whatever. Giving his fight four more months would have been what he wanted, and therefore worth every penny. You have no right to tell me my view is wrong. You don't know me, nor did you know my father, and you have no right to read your assumptions into his life, his fight for his life, or my relationship with him.

My father ran out of options. He went on four different chemo regimens. The first caused severe side effects. He developed a severe allergy to the second. A third caused more severe side effects. The fourth simply did not work at all. When he realized that he was out of options, he simply stopped eating, and died of an infection in a severely weakened state. He essentially ended his life on his terms, and I would never have denied him that option. However, if he'd had a viable option to extend his life and his fight, even for four months, he would have chosen to do so, simply out of love for his family and his wish to stay with us - and I would have supported him in that decision.

I've written several really caustic things after this and deleted them, but instead of completely going off and ripping into you, I will say what really bothered me about your post. While you certainly have a right to your own opinions based on your life experience, and you have the right to disagree with what I've said, telling me that I'm wrong is way out of line. I'm very glad that this conversation didn't happen in person, because I had the option of crafting a response much more carefully than the visceral, furious responses that came to mind. I hope you are more careful with your words in the future, because I found the wording of your response extraordinarily offensive. You did not have enough information to tell me that I was wrong, nor did you have enough information to discern whether I was being selfish.

[Swede]

29. Yes it is.

We have to do this,there is no other way.

[COLGATE4]

31. We're rapidly coming to the point where we really need to have

an intelligent discussion about end of life issues. The fact that a person's life can be prolonged at a cost of $93,000 is exciting, but is it really something that we should necessarily do? You can't rely on anecdotal experience here - almost anyone who has been involved in a decision of that nature will certainly side with keeping the loved one alive, even for a day. But that is not realistic policy. When does the fact that we CAN do something not mean that we SHOULD do it?

[walldude]

32. That was the whole point of the "Death Panels"

End of life counseling. But no, Republicans can't have you making those decisions. If Terry Shaivo had done that they wouldn't have been able to have their little religious circus.

[TBF]

33. I'd cut a lot of defense spending to make it affordable -

but we also need to ask who is going to get it? President Obama - will he be allowed to have it if he gets sick? What about Average Jane retail worker - is she going to be able to get treatment when she gets breast cancer and needs one of the costly drugs? What about John Doe homeless? We're not going to spend any money on him are we?

This is why we need Medicare for all, and then we need to look at our budget and decide what we're going to have to cut (ie Offensive Wars in which we search for mythical WMD would be the starting point for me) ... so we can give a decent level of coverage to folks across the board.

Right now 1% of this country is making 20% of the income off the top, and controls about 40% of the wealth. Warren Buffet, he's gonna get any damned medicine he wants. The rest of us - not so much.

[spanone]

34. with the profits in cancer treatment, it may never find a cure

[BrklynLiberal]

39. Bingo! There are those who believe exactly that!!!

Cancer treatment is BIG BUSINESS...and not just for Big Pharma...

and if all the products that are suspected of causing cancer were removed from our lives, there would be many jobs, and lots of money lost.

Aside from among those individual patients who suffer from cancer, there is no incentive to actually find a cure.

[BrklynLiberal]

35. I would not question the worth of the treatment, but the astronomical cost of it.

Perhaps if there were not so many hands in the pot, each looking for a huge profit, it might not cost such a ridiculous amount.

Would this cost be as much in Canada, France or Great Britain????

[pitohui]

53. a poster upthread said her mom in canada is paying $8 for alimta

$8 versus what is it, $50K a treatment in some american hospital -- if that post is correct, all i can conclude is that the cost of these treatments is theft, pure and simple, it is extortion of the sick and dying

[Radical Activist]

38. This is why we don't need a single payer system.

Every medical decision will be a huge public debate because the government will be making decisions. Make the insurance industry be non-profit co-ops. People can choose the coverage they want and it will take the profit motive out of health insurance.

[Gormy Cuss]

43. If we had single payer the drug companies would offer these drugs at a more competitive price

just as they do in Canada and other countries with single payer or national health.

[Radical Activist]

49. Or they would just milk the federal government for all they can

like they do now with medicaid and medicare.

[Gormy Cuss]

58. Hard to do that when there's only one buyer.

See Canada.

[Radical Activist]

60. If big pharma runs the government now

why would that suddenly change with a single-payer plan? That's not a rational expectation.

[Gormy Cuss]

62. Because our single payer can point to the negotiated prices in other countries

as a bargaining chip, assuming our government negotiators are more astute than the members of the cat food commission.

[Radical Activist]

64. And when a Republican President appoints pharma execs

to be in charge of negotiations then what exactly do you think will happen? There are inherent problems with giving that much power to a government that can easily be placed in the wrong hands.

[Gormy Cuss]

83. We have lots of things to fear when a Republican is president.

Once single payer is in place and people see how much easier it is, it will be another political third rail. That's why the pharma lobbyists have worked so hard to make sure it doesn't happen.

[walldude]

74. Because Big Pharma has options...

If there were no options, Big Pharma would have to do what they are told. No more 300% fucking profits from people who are dying.

[leftstreet]

67. Nonsense. There's no public debate over Medicare decisions

The public doesn't debate how seniors should spend their SS

:eyes:

What a rightwing argument

[Radical Activist]

69. You're seeing the debate right here.

These debates happen in England all the time. The reality is in front of your face.

[leftstreet]

71. No. The debate here is about Capitalists profiting off our healthcare

The 'Sarah Palin Death Panels' talking point is no different than the 'Public Outcry' talking point

These talking points are interjected to PREVENT the true debate

But then you know that

[sally cat]

41. If the drug company donates it, yes. Plus whose word do we have that it does extend life 120 days?

[Zephie]

46. If I had cancer, I'd rather die than pay that. My family could use that money

[pitohui]

55. esp. since most who pay that will die anyway

so what are you paying for, really? in most cases, it seems you're paying a very high price to be an experimental animal

what are all these cancer fund raisers for? supposedly we all donate millions to this research, yet then the drug companies have the nerve to claim that they need to charge extortionate prices for the research? w ell, what happened to all that donated money? every woman in america bought a fucking pink ribbon last month, where did that money go? i've never heard any poor or middle class person said susan kamen helped pay for their cancer drugs...

a friend of mine diagnosed w. cancer told no one and simply kept up the pretense until she died rather suddenly, active and able to do as she pleased almost to the end, since she wasn't doing chemo

yes, we were shocked when she passed without warning, but at least she went out on her terms, instead of suffering as a "patient" while enriching someone else at her family's expense...there are cancers where i believe her choice was prob. the one i would make also

[w8liftinglady]

73. that was my dad's thought,as well. Hospice is a godsend

If the quality of life were high,it would be one thing.
i can only go by my experience with HIV and cancer patients.
The last few months are difficult.Hopefully,the patient is made aware of the risk/benefit beforehand.The physicians i worked with,for the most part,were good about being honest about treatment,life expectancy.When given all the facts,people GENERALLY choose to avoid this type of aggressive/futile treatment when they are end-stage.
(BTW-my healthcare costs were 350K,last I checked...so it IS worth it some of the time)

[walldude]

75. Yup and I have lived with cancer victims..

those last few months are horrible. Most people wouldn't want it.

[Bluebear]

50. If we can afford Wall Street bailouts & bonuses which are much more expensive, I'd say yes.

[Donald Ian Rankin]

51. I believe the standard used in the UK is £20-40,000 per quality-adjusted life-year.

Here in the UK, the board that decides which treatments to fund - I think it's the National Institute for Clinical Excellence, or NICE for short, Orwellianly - bases its decisions on a measure called "quality-adjusted life-years". It keeps the actual amount a drug has to cost per qualy to be accepted secret, to stop drug companies pricing all their products just below that mark, but I believe it's somewhere around £30,000.

This drug sounds like you're looking at nearly ten times that much, so it would almost certainly not be made available on th NHS here, I suspect.

[Desertrose]

52. Measuring life in dollars...

....who ARE we???

[GSLevel9]

54. well... if it's YOUR money and YOU earned it...

if you can spend a big chunk of your savings on meds to live a few more months... that's YOUR business.

[SweetieD]

61. What is one day of life worth to you?

[Better Believe It]

63. It's available to everyone who is rich. Therefore everyone should be covered under Medicare

[Gin]

65. did we ever get the option for the gov. to use its size to negotiate

cost of drugs?

[RT Atlanta]

66. I dunno...

It obviously depends on your perspective and whether you're the one needing the treatment. Of course, pain, quality of life, etc. should all be factored in.

"All my possessions for a moment of time."
Elizabeth I
English queen 1558-1603 (1533 - 1603)

[entanglement]

68. Things will get a lot worse before people realize the incompatibility of the "for-profit" healthcare

model with their health, dignity and well-being.

[mainer]

70. What if it's this vs. vaccinations for countless kids?

When public funds are limited, there will have to be some sort of cost to benefit decision made.

[CrawlingChaos]

72. Who do you have to know (or blow) to get these treatments?

Seriously. We fought like demons and we couldn't get a lousy six-week course of Carboplatin chemotherapy for my Mom, which had a 65% chance of extending her life by up to two years, and more importantly, relieving her pain. We got three weeks into it and the oncology dept. at Kaiser Permanente (Santa Clara, CA) pulled the plug on her treatment. No explanation. She was tolerating it just fine - no side effects or infections.

They wanted her in hospice and we were manipulated and coerced into it, where everything will be denied. Hospice is euthanasia, btw. Let's cut the crap on that one. At some point it becomes appropriate, perhaps, but when you are going through it, you can see it for what it is.

The doctors lied to us and told us chemo had a 25% chance of working, but when a hospice nurse left her file open at my Mom's home, we could see that the true estimate was put at 65%. Whatever it takes to get you die quickly and cheaply.

So I have to shake my head at these expensive treatments and wonder what secret club you have to belong to in order to get them. Because very basic care is already being denied to ordinary folks like my Mom.

[Catbird]

76. Limitations of cancer drugs

I watched my husband die of kidney cancer, including some treatment with targeted therapies. They did prolong hope, but I doubt that they actually prolonged life. The documented extensions of life are so small that it's not really clear what's going on and what would have happened without the drugs. If I end up with terminal cancer someday, the drug I want is MORPHINE! It's not easy to deal with end-of-life issues, but delusion and denial are dead ends .

[CrawlingChaos]

81. I was not in delusion or denial

What are you saying - don't even try the available treatments?

We were not looking for unrealistic extension of life in my Mom's case. The chemo was classified as palliative - to shrink her cancer and give her some degree of comfort in whatever time she had left to her. Are you saying we were delusional to think that was worth trying?

So you would choose only morphine in the face of a terminal cancer diagnosis - that's fine for you and that's your choice. Would you deny others treatment if they want it (or brand them delusional)? I'm trying to understand your point here.

I'm sorry for the loss of your husband.

[JoePhilly]

77. What kind of care would Cheney or Bush get in this situation??

[La Lioness Priyanka]

79. i want to know why it was that expensive not if four months are worth it

[WinkyDink]

80. This is an attempt to restrict use of medicine (Cf., "The UK"). "Four months" is a meaningless guess

intended to diminish both hope and approval.

[Warren DeMontague]

85. That depends. Is it my 4 months, or someone else's?

If people want it, they should get it.

Jesus.

[Cleita]

89. I suppose if it's the four months of one of our illustrious

leaders either past and present, like Dick Cheney, sure it's worth it. If it's your uncle Oscar, probably not so much.

:sarcasm:

[amborin]

91. yes; my mother died of breast cancer, and a mere four months becomes a cherished eternity from that

perspective; every form of cancer is different, with different trajectories, responses to treatments, etc...so generalizing doesn't yield much

if 4 months seems too short to justify the expense, to some, then how long a potential survival time is enough? where does one draw the line? one year? 5 years? 10?

it's interesting that we, proles, are debating whether or not a cancer patient should receive expensive drugs, while the mega-wealthy elite grow ever richer, at public taxpayers' expense, and profligately spend millions on baubles

that's what we're reduced to

[hayu_lol]

92. One of the good things about living in Oregon...

we do have our 'death with dignity' law, legal euthanasia for terminally-ill patients. More important to the very ill and the very senior who are able to make the decision themselves. We do more for pets than we do for people.

Obviously, there are mobs on both sides of this question. Many seniors I've talked to(and I am a senior)are against prolonging our lives when the quality of life becomes only an academic question. No one wants to be a veggie or someone in terrible pain. Doctors today tend not to proscribe enough painkillers with the law looking over their shoulder.

Some people will fight for every second of life, others of us are more likely to simply go for making us as comfortable as possible to the end. But to put a price on it is not reasonable. Common sense, when available, says to go when it is time.

Age would be/should be a huge factor in making a determination to use these very expensive drugs/treatments.

[amborin]

95. i appreciate your reponse

but strongly disagree that "age ....should be a huge factor in making determination to use these very expensive drugs...."

also, you juxtapose "fighting for every second of life".... with "going for making us as comfortable as possible to the end," yet these are not mutually exclusive

[Lucian]

93. There is NO need for a fuckng drug to be $1,206,000.

NO. FUCKING. NEED.

This is why we need single payer.

[bluetrain]

97. Of course it's worth it, if the patient wants to live. You can't put a price on life.

Quantifying the worth of existence is not the issue here. That companies are allowed to withhold life saving (and bettering) treatments of a fee (of any kind) is.