There’s more chatter lately (see the Seattle Times, The Newest Generation of Drugs: Who Can Afford Them?) about the cost of the growing list of biotech drugs “(“biologics”) that can lengthen your life and/or improve the quality of your life when you are living with an advanced cancer or a long-term chronic illness like multiple sclerosis or rheumatoid arthritis (“RA”).
In RA, for example, there are drugs like Orencia, Enbrel, Humira, and Remicade. In Hepatitis C, a rampant chronic illness, Intron-A can cost $3,473 per month. An advanced breast cancer drug, Tykerb, costs $3,021 a month. People with MS have a “bargain” with Copaxone costing only $1,991 per month.
Yes, millions of people have insurance. And yes, Montel Williams buses around the country and television telling us the drug companies provide support for people who are having trouble making ends meet. But a lot of people are still having to make tough choices – pay the rent or buy groceries or pay their share for the biologic medicine that makes life worth living and takes away their pain or keeps their disease at bay.
The problem, beyond people who lack insurance at all (the topic for another blog), is that people with insurance are increasingly finding the carrier – including Medicare plans – shifting costs to them. Instead of giving them higher, but fixed, co-pays for their share of biologics, they are being asked to pay a percentage – even up to 50%!
Many people who read this on our Patient Power site may know this all too well. But a growing population of Americans will soon see it’s their problem too. As we age, more of us will have a chronic illness that can be helped with a biologic or we’ll have a cancer we can live with if a biologic becomes part of our long-term treatment. In 2007, insurance industry analysts say the cost for these biotech drugs was $59 billion. In 2011 they expect it to be $98 billion.
So ask yourself, who should share the risk to cover these costs? Should it be the small, but growing number of people who need these drugs? Or should it be a revised system and maybe National Healthcare Insurance? I am a supporter of the latter, but I am sure you have your own view and I hope you will share it share it.
You can see the dilemma. As we have discussed all over Patient Power, we are in an era of “personalized medicine.” And drug companies have been developing, at great cost, targeted immune-modulators that are having success for specific types of patients in fighting back against cancer and auto-immune conditions. But no drug company will develop such a drug if they can’t get paid back, and then some for their investors.
To be clear, we are not talking about “me-too” drugs or once a day formulations of a generic you can take 3-4 times a day and will be less expensive and do just as well. We are talking about unique biologics that let you walk or work, when you otherwise could not.
Two other notes: 1) Even episodic cancer drugs can be hugely expensive. A former colleague who is fighting advanced colon cancer and thankfully now showing “no evidence of disease” told me the bill for his drug therapy in one day last winter was $37,000! He is alive today, working, and the parent of two lovely young kids. Was this money well spent? This is the healthcare economic debate we have to face as the load gets ever heavier and the burden on some individuals (and employers) unfairly too high. Shouldn’t we be able to count on insurance to be our safety net? As you can see from the above, maybe not. And, as observers say, it has us questioning the tradition answer to “what is insurance?.”
2) An obituary – 53-year-old Leroy Sievers, a veteran journalist who chronicled his life as a cancer survivor on National Public Radio, died Friday. For 25 years, he covered the stories of the world but now may be best remembered for telling his own story of fighting colon cancer. I know many will miss him. His contributions were a blessing. While no one knows what our own health journey may have in store for us, you may have a story to tell – and hopefully, a long life! Please share yours with us in text, and soon with contributions on video, too share it.
Reminding you that Knowledge Can Be The Best Medicine of All, and wishing you and your family the best of health,
Andrew