Can Doctors Choose Between Saving Lives and Saving a Fortune?

By SIDDHARTHA MUKHERJE

America is great, they say! America is medically advanced — they have the best medicine, the best brains, etc. etc. But American is burdened by the most expensive health care cost in the world. Many Americans go bankrupt after being sick — especially after getting medical treatments for their cancer.

We in the developing countries are going to suffer similar fate like the Americans if we follow the so called Great American medical system!

Dr. Siddhartha Mukherje wrote this article in the New York Times.

Can Doctors Choose Between Saving Lives and Saving a Fortune?

To understand something about the spiraling cost of health care in the United States, we might begin with a typical conundrum:

Imagine a 60-something man — a nonsmoker, overweight, with diabetes — who has just survived a heart attack. Perhaps he had an angioplasty, with the placement of a stent, to open his arteries. The doctor’s job is to keep the vessels open.

The doctor has two choices of medicines to reduce the risk for a second heart attack.

  • There’s Plavix, a tried-and-tested blood thinner, that prevents clot formation; the generic version of the drug costs as little as 25 cents a pill.
  • And there’s Brilinta, a newer medicine that is also effective in clot prevention; it costs about $6.50 a pill — 25 times as much.

Brilinta is admittedly more effective than Plavix — by a 2 percentage points.

In a yearlong trial of 18,600 patients, 10 percent died from vascular causes, heart attack or stroke on Brilinta, while about 12 percent did on Plavix.

Should the doctor prescribe the best possible medicine, assuming that the man has private health insurance that will pay the bulk of the costs? Or should the doctor try to conserve health care costs by prescribing the cheaper medicine that is nearly as good?

“We thought about this nearly every day when discharging patients from the cardiology unit,” Dhruv Khullar, a newly minted hospital attending, told me. “Some of us believed that a doctor’s job is to deliver the best possible care.

Others argued that doctors should aim to find some balance between medical benefit, financial cost and social responsibility.

It’s the kind of question that we aren’t really trained to solve. Are costs something that an individual doctor should do something about? What is a doctor supposed to do?”

The authors, Irene Papanicolas, Liana Woskie and Ashish Jha, wrote …. the United States is a sore-thumb outlier among 11 wealthy nations in medical spending. We spend 18 percent of our G.D.P. on health care, while Australia, Canada, Denmark and Japan seem to make do with about half that amount.

Yet life expectancy in the United States is the lowest in the group, and infant mortality is the highest. Our out-of-control prices have a stifling effect on the economy.

So what is driving the cost? Each time we did go to a doctor, it seems, we managed to spend more. Tests were ordered more frequently: We sat inside M.R.I. and CT scanners more often than patients in most other countries.

We had high-cost surgical procedures performed more often than most other populations in the world. Knee replacements, cataract surgeries, cesarean deliveries, coronary-bypass grafts, angioplasty.

On average, though, the United States ranked among the highest in most operations. Many of these procedures cost more in America (an M.R.I. costs $1,150 in the United States and $140 in Switzerland; it’s hard to insist that an American M.R.I. is eight times as good).

And some of these procedures inevitably led to complications, and then we paid for those complications. The impact on overall life expectancy was evidently minimal.

The United States leads developed nations in what the surgeon and writer Atul Gawande has called an epidemic of “overtesting, overdiagnosis and overtreatment.”

If expensive procedures explain some of the costs accrued by Americans, pharmaceutical prices and spending offer an even more alarming explanation. We spent $1,443 annually per person (yes, you read that number right) on drugs — in part because each medicine costs us more, and in part because we used new drugs that weren’t even available in many other countries.

Humira, the treatment for rheumatoid arthritis, was priced at $2,500 per month in the United States versus $980 in Japan and France.

Lantus, the long-acting form of insulin, cost us $186 per month, four times the price in France. Adding pharmaceutical insult to injury, many more expensive drugs were invented in America — and yet we paid more than any other rich nation to use them ourselves.

Source: https://www.nytimes.com/2018/04/03/magazine/can-doctors-choose-between-saving-lives-and-saving-a-fortune.html?em_pos=small&emc=edit_ma_20180406&nl=magazine&nl_art=0&nlid=54459356emc%3Dedit_ma_20180406&ref=headline&te=1

 

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Financial Toxicity, A New Name for a Growing Problem

A growing body of literature has described the so called “financial toxicity” of cancer, a common consequence of treatments, that sometimes leads patients to bankruptcy, and affects quality of life and clinical outcome. It’s not just a matter of empty wallets: the lack of money and the loss of income is a cause of distress that interfere with the efficacy of treatments. Financial toxicity has been studied in the US and other countries with a private health care system.

You can read the article: http://cancerworld.net/spotlight-on/the-toxic-effects-of-hidden-costs/

“We don’t travel; we don’t do anything now because it’s a $100,000 illness. And it sucks.… What are you going to do? Caught between a rock and a hard spot.”

A 67-year-old, insured woman with metastatic breast cancer— let’s call her “Janet”— recently described how her life changed due to costs of cancer care. We all hear about the cost of care at every turn …..

….. Oncologists who treat patients daily listen to similar life-altering, cost-related complaints, along with reports of fatigue, nausea, and pain.

However, to date most of us have not considered financial distress in the same vein as chemotherapy-induced toxicity, nor do we have the training to alleviate that distress. In this, the first part of a two-part series, we will describe the patient-level impact of the cost of cancer care, what we call “financial toxicity.”

More: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4523887/

 

 

 

 

 

The High Cost of Cancer Drugs ….

by: Mustaqeem Siddiqui and S. Vincent Rajkumar

Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3538397/

Iipilimumab or Yervoy was approved by the US FDA for the treatment of metastatic melanoma.

The benefit in survival was 3.7 months in previously treated patients and 2.1 months in previously untreated patients.(Note: It treats but does not cure!)

The cost: USD $120,000 for 4 doses (that is almost half a million Malaysian ringgit). A real staggering figure indeed! We are now entering a mind-boggling era of high host cancer treatments. Here are more …. shocks!

 

Drug Cancer Cost USD / RM Comments
Sipuleucel-T or Provenge; Prostate cancer

     90,000 for 3            doses                   RM 360,000

 
Bevacizumab or Avastin Lung, colon and others

90,000

RM 360,000

Can be continued >1 y until disease progression
Paclitaxel, protein-bound or Abraxane Breast cancer

         80,000         RM 320,00

Continued until disease progression
Lenalidomide or Revlimid Multiple myeloma

        90,000              RM 360,000

In frontline and maintenance, duration of therapy can exceed 3 y; in relapsed disease, duration is approximately 1 y
Bortezomib or Velcade Multiple myeloma

       60,000             RM 240,000

Can be continued >1 y until disease progression
Imatinib or Gleevec; Chronic myeloid leukemia

       70,000            RM 280,000

Lifelong until progression
Alemtuzumab or Campath Chronic leukemias

         70,000           RM 280,000

Could be used for >1 y
Ofatumumab or Arzerra Lymphomas and chronic lymphoid leukemias

        120,000            RM 480,000

Could be used for >1 y
Brentuximab or Adcetris Hodgkin lymphoma        100,000             RM 400,000 Approximately 6-8 cycles in a year
  • The costs listed are approximate estimates based on average wholesale prices and typical schedules used in practice. Costs are higher when the cost of administration is factored in and when 2 or more drugs are used in combination.
  • Approximate conversion rate of 1 USD = RM 4.00

Indeed, the percentage of personal bankruptcies in the United States attributed to health care costs rose from 46.2% in 2001 to 69.1% in 2007.

…Many of us, particularly oncologists and hematologists, repeatedly ask ourselves the following questions: “Why are cancer drugs so expensive?” “What polices or interventions can be employed to lower the cost of cancer drugs?”

 

Many cancer patients don’t even feel sick until they start treatment!

Being diagnosed with cancer is not only bad, it’s an extremely scary and unpredictable time in your life.
But there’s something even worse…

The treatments.

Invasive surgery, destructive radiation and toxic chemotherapy… all of which can be much WORSE than the actual cancer itself.

The truth is, many cancer patients don’t even feel sick until they start treatment!

Well… It’s time to discover a different approach.

You remember my dear friend Chris Wark who was in our docu-series, The Truth About Cancer, and also speaks at our events…

Well, he’s a 13-year stage III colon cancer survivor who decided to take matters into his own hands when he was diagnosed.

His results (and exactly HOW he did it) are nothing short of amazing.

Go here to see how he did it.

Most people blindsided by a cancer diagnosis, won’t have or get this vital information and will have to rely solely on the limited options their doctor gives them.

Please don’t let that happen to you or someone you love.

Go here to see how Chris beat cancer.

Explore your options and alternatives to conventional treatments.

It could make all the difference in the world.

Ty Bollinger

Pharma companies are ‘getting away with murder’

Try to google this: Trump says drug company get away with murder and you get to this link:

https://www.google.com.my/search?safe=strict&site=webhp&q=trump+drug+company+get+away+with+murder&spell=1&sa=X&ved=0ahUKEwiL2cH15rvRAhVLFZQKHch3DjsQvwUIGCgA&biw=1538&bih=726&dpr=1.25

  • S. President-elect Donald Trump on Wednesday said pharmaceutical companies are “getting away with murder” in what they charge the government for medicines, and promised that would change, sending drugs stocks sharply lower.
  • Trump on drug prices: Pharma companies are ‘getting away with murder’

SAN FRANCISCO — At his first news conference as president-elect on Wednesday, Donald Trump accused the pharmaceutical industry of “getting away with murder” and said that he would change the way the country bids on drugs to bring prices and spending down.

“Pharma has a lot of lobbies, a lot of lobbyists and a lot of power. And there’s very little bidding on drugs,” Trump said during the event at Trump Tower in New York. “We’re the largest buyer of drugs in the world, and yet we don’t bid properly.”

Federal law forbids the government from negotiating with drug companies to bring down the price of drugs for seniors using Medicare. While Trump did not announce a specific plan to address the issue, he has in the past called for ending the policy — a proposal that Democratic lawmakers have repeatedly put forward.

  • Drug stocks tanked after President-elect Donald Trump, in his first press conference since the election, complained about big price increases and put the industry on notice. Trump said that many companies were “getting away with murder” and that there would be more competitive bidding practices for federal contracts in his administration.
  • NEW YORKS. President-elect Donald Trump on Wednesday said pharmaceutical companies are “getting away with murder” in what they charge the government for medicines, and promised that would change, sending drugs stocks sharply lower.
  • President-elect Donald Trump went after drug makers in the opening remarks of his press conference Wednesday, calling the industry’s practices “disastrous” and suggested the government should negotiate drug prices. Trump had endorsed having Medicare negotiate drug prices — a long-time Democratic position which Republicans have opposed. “The other thing we have to do is create new bidding procedures for the drug industry, because they’re getting away with murder, pharma. Pharma has a lot of lobbies, a lot of lobbyists, a lot of power. And there’s very little bidding on drugs,” he said.

 

 

 

Drug Goes From $13.50 a Tablet to $750, Overnight

Big Pharma greed on parade and out of control

The total greed of Big Pharma is on parade this week as a company called Turing Pharmaceuticals took ownership of a lifesaving medication that treats parasitic infections like malaria. The pill — mostly purchased by AIDS and cancer patients — used to cost $1 each. But now, thanks to Turing Pharmaceuticals and its profiteering CEO Martin Shkreli, each pill will cost you $750.

Why is Turing Pharmaceuticals charging $750 a pill? Because they CAN. Like every other drug company in the world, they’re going to gouge the consumer and extract the maximum dollars possible. Big Pharma is really about the profits, you see, and not at all interested in “helping humanity” as their ridiculous TV ads claim.

This Daraprim pill, by the way, probably costs about 20 cents to manufacture, and it’s probably manufactured in India or Puerto Rico, where most drugs are made and then exported to the USA. How does Turing Pharmaceuticals justify $750 a pill? According to the pharma douchebag Martin Shkreli, it’s “a bargain for health insurers” at $750.

A bargain compared to what? A bargain compared to all the other monopoly-priced drugs, he says. And that’s how insane the monopoly has become, by the way: When a pill that sells for $750 is called “a bargain,” you know you’re living under a monopolistic profiteering medical cartel. And it is, truly, a protected cartel. Who’s protecting it? The corrupt government, of course… starting with the FDA.

Learn more: http://www.naturalnews.com/051270_Big_Pharma_profiteering_Turing_Pharmaceuticals_price_gouging.html#ixzz3nhNmBhAN

http://www.nytimes.com/2015/09/21/business/a-huge-overnight-increase-in-a-drugs-price-raises-protests.html?_r=0