During the initial debate on healthcare reform, those who spoke about “death panels” were called fear mongers. And, to a large degree that’s what they were trying to accomplish. But the issue is a real one. We spend a disproportionate share of our on what is loosely termed “end of life care.” And it’s an issue we have to address. Now. Unless we are willing to surrender to Uncle Sam, MD and the $50,000 QALY and adopt a lowest common denominator of “care we can afford,” we’d better place this issue near the top of our national healthcare conversation.
And so, kudos to Marilynn Marchione of the Associated Press, who asks the question nobody wants to address … what’s a life worth?
BOSTON — Cancer patients, brace yourselves. Many new drug treatments cost nearly $100,000 a year, sparking fresh debate about how much a few months more of life is worth.
The latest is Provenge, a first-of-a-kind therapy approved in April. It costs $93,000 and adds four months' survival, on average, for men with incurable prostate tumors.
For the last decade, new cancer-fighting drugs have been topping $5,000 a month. Only a few of these keep cancer in remission so long that they are, in effect, cures. For most people, the drugs may buy a few months or years. Insurers usually pay if Medicare pays. But some people have lifetime caps and more people are uninsured because of job layoffs in the recession. The nation's new health care law eliminates these lifetime limits for plans that were issued or renewed on Sept. 23 or later.
Unlike drugs that people can try for a month or two and keep using only if they keep responding, Provenge is an all-or-nothing $93,000 gamble. It's a one-time treatment to train the immune system to fight prostate tumors, the first so-called "cancer vaccine."
I'm fearful that this will become a drug for people with more resources and less available for people with less resources," said M.D. Anderson's cancer research chief, Dr. Christopher Logothetis.
When is a drug considered cost-effective?
The most widely quoted figure is $50,000 for a year of life, "though it has been that for decades — never really adjusted — and not written in stone," said Dr. Harlan Krumholz, a Yale University expert on health care costs.
Logothetis said Provenge and other experimental cancer vaccines in development need "a national investment" to sort out their potential, starting with Medicare coverage.
"It's no longer a fringe science. This is working," he said. "We need to get it in the door so we can evolve it."
The complete AP story can be found here.
