Perhaps this is a bit too much self-disclosure, but my father is battling pancreatic cancer. So articles on cancer treatment tend to catch my eye, as a son who would like to find the best care and treatment to prolong his life. He’s beaten the odds already, as he’s one of the 25 percent of patients with this disease who makes it three years post diagnosis and still walks the face of the earth.
Sometimes only just barely, but he’s alive and kicking and fighting the disease the best he can. Lucky for him that he lives close enough to Baltimore, Maryland and Johns Hopkins Medical Center, where the world’s most well-known experts on pancreatic cancer work their magic.
No surprise, given my dad’s situation, that the article Hope, at $4,200 a Dose in today’s New York Times caught my eye, as it talks about cancer treatments and illustrates just how out of control health care costs are in this country.
Imagine this: Someone figures out how to re-package the drug Taxol in such a way that it reduces some of Taxol’s side effects and then that person has the audacity to charge $4,200 a dose for it, when the generic equivalent of Taxol costs about $150 a dose. If you were given the choice, barring an allergy to the current formulation of Taxol, which one would you choose? Me, I’d go for the $150 version, especially if I was told that both Taxol and the new drug, Abraxane, have the same long-term effectiveness. And that’s precisely the case in this story.
Drug effectiveness, for cancer drugs, is measured by how many patients are still alive at various times after they’ve begun their treatment. For both drugs, after 2 years only one-quarter of the patients on either medication will still be alive. Not the greatest of odds, eh? But if you’re desperate, you’ll try anything and you’ll hope you’re one of the lucky ones.
I know I would.
One of the twists to this story is that Abraxane appears to have a bit more success in shrinking cancer tumors, at least to some extent. How much shrinkage the article doesn’t specify. But neither drug is a stellar performer. The “new, improved” version only works (to whatever degree) in just under one quarter of all the patients who receive the medication. Imagine that. Abraxane is ineffective more than 75 percent of the time. Mind you, Taxol only works in about 11 percent of patients who receive the medication, meaning it’s ineffective 89 percent of the time.
Given the high price of these medications, perhaps the pharmaceutical companies might offer a money-back guarantee? Not bloody likely, eh? But what the high fees for Abraxane has done is made a billionaire out of the company’s founder. Now, if he’d invented a truly unique, new drug that was effective for a majority of patients who use it, I wouldn’t begrudge him his billions. But that’s not the case. It’s not really a new drug (if you read to the last paragraph of the story, you’ll even find that the company’s chief medical officer admits that Abraxane is not really a new drug) and it doesn’t work for the majority of patients who receive it.
Each one has a pretty lousy track record. But these drugs are used for late-term breast cancer patients, so the people receiving the medication are not in good shape to begin with. When you’re going for last resort treatments, you’re betting that you’re one of the people for whom the medication is actually going to work.
I can’t imagine that it is so expensive to produce this newer version of Taxol that the $4,200 price tag per dose is worth it. I know desperate people will pay exorbitant amounts in order to get treatments that have only a slim chance of working, but at some point, someone needs to step up and tell the manufacturers that there is a limit to just how much they can plunder the patient’s pocketbooks. I’m guessing that a reasonable price for Abraxane is somewhere in between the cost of the generic equivalent of Taxol and the brand-name drug.
Because one way or another, it comes out of the patient’s pocketbook — either as a co-pay or as a higher insurance premium. And higher insurance premiums seem to be almost as certain as death and taxes these days.
So what can be done? Here’s a novel idea: Medicare is one of the largest insurers that covers these treatments. Perhaps Medicare should be able to negotiate the price of medication with the manufacturers? Wouldn’t that be in the public interest? But no, Medicare was barred from negotiating prices with drug companies when the whole prescription drug benefit was created for senior citizens.
What a scam. The drug lobbyists managed to preserve their obscene profits in this country (they make more than half of all their world-wide profits from drug sales in the US), and it doesn’t save the average senior (or anyone else on Medicare, either) a damn penny.
As a friend of mine used to say, “For every opportunity, there’s an opportunist.”
