How Drug Companies Price
Of all the appalling things we deal with when it comes to modern medicine, Big Pharma is the worst. |
The One Word
every cancer patient must know
Your doctor's reading the results, you know it's the worst news, and you snap out of it just in time to hear him say...
"I'm going to recommend an aggressive chemotherapy regimen." That's when you say one word that sucks the air out of the entire doctor's office. It's a new cancer therapy that doctors are whispering about behind closed doors...and doctors will be stunned you know about it. $4 billion has already been spent researching it--making it one of the largest research initiatives in medical history. And the results are powerful--Tumor shrinkage in 86% of lung cancer patients. Once "incurable" brain tumors put on hold. And these revelations are already rushing 374 clinical trials into hospitals. But you can't call this new hope therapy "aggressive" like chemo, because there is no poison, there are no toxins. In fact, this therapy could have you alive and thriving. Find out the one word that will have your doctor asking, "how did you hear about this?" |
Drug prices related to medical illness are the leading cause of bankruptcy in the U.S. Many patients are required by their insurance providers to pay roughly 20 percent of the total cost of the drug. That quickly adds up to sky-rocketing out-of-pocket payments. Just in the last ten years, average monthly costs for cancer drugs have doubled, up from $5,000 to more than $10,000 per month.
In 2012, 11 out of the 12 new cancer drugs approved by the FDA were priced at well over $100,000 a year. We're not even talking about miracle drugs here. Only three of the 11 new drugs improved patient survival rates beyond a reasonable doubt. Two of those only boosted survival by two months.
Call me coldhearted, but I'm really and truly puzzled that people would pay more than $100,000 for two more months of life, especially two miserable months on chemo. I don't get it. For this we leave our spouses and children destitute?
Some of these patients are just following doctors' orders, but some are well-informed enough to know what they're doing — because many oncologists will tell a late-stage patient the 'official estimate' of just how much extra time another round of chemo will buy them. Most of the time the answer is "not much."
And the unofficial estimate is even worse — chemo shortens life as often as it extends it. For the late-stage patient it's a bust (literally, in terms of their bank account.) Of course, mainstream doctors don't know the "unofficial" figure — or claim they don't — but even their drug-company-provided estimate that you'll live two more weeks or two more months or whatever is so absurd, I marvel that patients go for it.
In 2012, 11 out of the 12 new cancer drugs approved by the FDA were priced at well over $100,000 a year. We're not even talking about miracle drugs here. Only three of the 11 new drugs improved patient survival rates beyond a reasonable doubt. Two of those only boosted survival by two months.
Call me coldhearted, but I'm really and truly puzzled that people would pay more than $100,000 for two more months of life, especially two miserable months on chemo. I don't get it. For this we leave our spouses and children destitute?
Some of these patients are just following doctors' orders, but some are well-informed enough to know what they're doing — because many oncologists will tell a late-stage patient the 'official estimate' of just how much extra time another round of chemo will buy them. Most of the time the answer is "not much."
And the unofficial estimate is even worse — chemo shortens life as often as it extends it. For the late-stage patient it's a bust (literally, in terms of their bank account.) Of course, mainstream doctors don't know the "unofficial" figure — or claim they don't — but even their drug-company-provided estimate that you'll live two more weeks or two more months or whatever is so absurd, I marvel that patients go for it.
They charge what they can get away with,
insurance companies will pay
insurance companies will pay
Most people don't realize that pharmaceutical companies are the ones who dictate price. All the FDA does is give approval. Then drug companies look at their research and development costs, factor in the expense of drugs that didn't get approval, add in education and ad costs, and then (I would guess) throw in a nice buffer for profits.
Here's more that'll make your blood boil: Some U.S. drug prices are two to four times as much as you'll pay for the same thing in other countries. And in the U.S., patients whose drug costs are covered by the Department of Veterans Affairs pay drug prices that are 50 percent lower than prices paid by Medicare patients—because the VA is allowed to negotiate drug payments and Medicare can't.
Worse still, U.S. drug manufacturers can actually pay the makers of generic drugs to keep their cheaper versions of a drug off the market for a limited period of time (usually a number of months). It's called "pay to delay" and brings clear profits. According to Ralph Neas, president of the Generic Pharmaceutical Association, healthcare spending was reduced by more than $1 trillion thanks to earlier introduction of generic drugs over the past 10 years.2
We need to see the same thing happen with cancer treatment and drugs.
Here's more that'll make your blood boil: Some U.S. drug prices are two to four times as much as you'll pay for the same thing in other countries. And in the U.S., patients whose drug costs are covered by the Department of Veterans Affairs pay drug prices that are 50 percent lower than prices paid by Medicare patients—because the VA is allowed to negotiate drug payments and Medicare can't.
Worse still, U.S. drug manufacturers can actually pay the makers of generic drugs to keep their cheaper versions of a drug off the market for a limited period of time (usually a number of months). It's called "pay to delay" and brings clear profits. According to Ralph Neas, president of the Generic Pharmaceutical Association, healthcare spending was reduced by more than $1 trillion thanks to earlier introduction of generic drugs over the past 10 years.2
We need to see the same thing happen with cancer treatment and drugs.
Why Big Pharma drives thousands
of people to bankruptcy
of people to bankruptcy
The 120 doctors who published a protest are specialists in chronic myeloid leukemia (CML), a condition for which a daily drug is commonly prescribed. The costs add up fast. The patients have to pay a high price just to stay alive. As the experts say in their protest, their patients are the financial victims of successful drug company tests.
New studies are finding that many CML patients and other cancer patients simply stop filling their prescriptions because they can't afford them. The American Cancer Society conducted a survey that found one cancer patient out of four puts off getting tests or treatments because of the exorbitant costs.
To defend themselves, the pharmaceutical companies claim high costs when it comes to drug development. But that defense falls flat when you look at companies like Swiss drug maker Novartis, the maker of Gleevac, which grossed a staggering $4.7 billion in sales last year alone.
Even one of the doctors who was part of developing Gleevac, Dr. Brian Druker, thinks Novartis has gone too far. After suggesting they could easily get by with a few billion less, Dr. Druker told The New York Times, "When do you cross the line from essential profits to profiteering?"1
This most recent outcry toward drug companies by the medical establishment was inspired by doctors from Memorial Sloan Kettering Cancer Center (MSKCC). Last year, those doctors refused to use Zaltrap, a new colon cancer drug, because it cost more than twice as much as a similar drug called Avatin. Yet, Zaltrap proved to be no better in terms of treatment outcomes than the cheaper Avatin.
The boycott at Memorial Sloan Kettering worked, and the manufacturer of Zaltrap has since cut the price by half. Interesting to note, though, was that the boycott crossed a major line—and set a precedent. Up till then, doctors were constantly under pressure to use any treatment that appeared to be new and better.
So while it seems like a no-brainer to boycott a drug that costs twice as high with no appreciable improvement in results … it actually raised some eyebrows, simply because doctors had never done anything like that before. (A "herd of independent minds" is the appropriate phrase for this profession.) The boycott was a step in the right direction — long overdue, in fact.
The reality is, most new drugs are no improvement over generic drugs that have been around for years, yet they're touted as a great new breakthrough and doctors dutifully prescribe them. I'm talking about ALL types of drugs, not just cancer drugs. The norm is for a "new" drug to be a minor tweak of an old drug. Or, even if a drug is genuinely new, in most cases it doesn't perform any better than older drugs that are off-patent and inexpensive. But the tweak or the mediocre "new discovery" can be protected by patent and priced accordingly.
But at least it's promising to know that so many oncologists out there have finally become mindful of the expensive technology and treatments they recommend. Soaring costs are pushing them to honor a new obligation, which is the consideration of financial strains they place on their patients when trying to treat them.
New studies are finding that many CML patients and other cancer patients simply stop filling their prescriptions because they can't afford them. The American Cancer Society conducted a survey that found one cancer patient out of four puts off getting tests or treatments because of the exorbitant costs.
To defend themselves, the pharmaceutical companies claim high costs when it comes to drug development. But that defense falls flat when you look at companies like Swiss drug maker Novartis, the maker of Gleevac, which grossed a staggering $4.7 billion in sales last year alone.
Even one of the doctors who was part of developing Gleevac, Dr. Brian Druker, thinks Novartis has gone too far. After suggesting they could easily get by with a few billion less, Dr. Druker told The New York Times, "When do you cross the line from essential profits to profiteering?"1
This most recent outcry toward drug companies by the medical establishment was inspired by doctors from Memorial Sloan Kettering Cancer Center (MSKCC). Last year, those doctors refused to use Zaltrap, a new colon cancer drug, because it cost more than twice as much as a similar drug called Avatin. Yet, Zaltrap proved to be no better in terms of treatment outcomes than the cheaper Avatin.
The boycott at Memorial Sloan Kettering worked, and the manufacturer of Zaltrap has since cut the price by half. Interesting to note, though, was that the boycott crossed a major line—and set a precedent. Up till then, doctors were constantly under pressure to use any treatment that appeared to be new and better.
So while it seems like a no-brainer to boycott a drug that costs twice as high with no appreciable improvement in results … it actually raised some eyebrows, simply because doctors had never done anything like that before. (A "herd of independent minds" is the appropriate phrase for this profession.) The boycott was a step in the right direction — long overdue, in fact.
The reality is, most new drugs are no improvement over generic drugs that have been around for years, yet they're touted as a great new breakthrough and doctors dutifully prescribe them. I'm talking about ALL types of drugs, not just cancer drugs. The norm is for a "new" drug to be a minor tweak of an old drug. Or, even if a drug is genuinely new, in most cases it doesn't perform any better than older drugs that are off-patent and inexpensive. But the tweak or the mediocre "new discovery" can be protected by patent and priced accordingly.
But at least it's promising to know that so many oncologists out there have finally become mindful of the expensive technology and treatments they recommend. Soaring costs are pushing them to honor a new obligation, which is the consideration of financial strains they place on their patients when trying to treat them.
Proactive lifestyle choices are still your best bet
The cost of cancer care is just one facet of a much bigger problem, the overall cost of conventional care. That's why I advocate as much proactive healthcare on your part as possible, so you can avoid this mess of money and greed in medicine.
I beg you with all my heart, get over the idea that you can neglect your health, let yourself go, eat and drink anything you like, adopt a "what-me-worry" attitude toward all the toxins around us — and somehow a miracle drug or high tech device will come along and make everything all right when you hit middle age or old age and your health falters.
I beg you with all my heart, get over the idea that you can neglect your health, let yourself go, eat and drink anything you like, adopt a "what-me-worry" attitude toward all the toxins around us — and somehow a miracle drug or high tech device will come along and make everything all right when you hit middle age or old age and your health falters.
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