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Showing posts with label cancer costs. Show all posts
Showing posts with label cancer costs. Show all posts

Wednesday, July 1, 2015

And the costs just keep piling up

Back at my first cancer adventure in 1981, my father advised me never to let my Blue Cross health insurance lapse because going forward with a pre-existing condition, I could always lose my health insurance. And that was something I could not afford. For quite a few years, until MA changed the law regarding pre-existing conditions, I would often pay for my own private health insurance to ensure I never lost Blue Cross. Even if my employer was offering another plan, I would pay for my own. That wasn't cheap.

Then I had more medical adventures and got to know the surgery department and ER a few more times. I kept my Blue Cross insurance and kept on paying. From time to time I would have a job which offered Blue Cross insurance. Then the law changed and I could stop that.

In the past 7 years since my second cancer adventure, I average a minimum of 50 doctor appointments each year. We max out our out of pocket coverage each year as well. One year a friend convinced to try to keep track of what insurance paid vs what I paid. No contest. I paid a tiny portion of the hundreds of thousands paid by the insurer.

So I am verification of a new study showing that after cancer, patients face rising costs of health care. All of a sudden you get more doctors and more appointments and everything needs to be checked because of your medical history, blah, blah, blah. And there are all the health issues caused by side effects of treatment that may never go away. The lost productivity costs because you have to go to the (damn) doctor or don't feel well enough to work that day. The list goes on.

But now it looks like a cancer diagnosis is financially as well as emotionally and physically taxing.


Friday, May 29, 2015

Going for the heart strings, of course

There was a new study (because we need a new study so the researchers don't have to polish up their CVs -  that's resume for the non-technical) that says there are more and more ads for cancer treatments and cancer treatment centers. Their results showed that:

"A systematic content analysis of these ads found that the content is sharply directed at a would-be patient’s heartstrings:

  – 85% made emotional appeals to consumers
  – 61% used language about hope, extension of life, or a cure
  – 52% touted innovative, or advanced technology or treatments
  – 30% evoked fear by mentioned death, fear, or loss


Nearly half of the advertisements included patient testimonials, but only 15% included a disclaimer about patient outcome. No advertisements described the outcomes a “typical” patient may experience. Failure to disclose this information is a violation of a Federal Trade Commission mandate, the report notes."

Only 2% of the ads disclosed the risks and 5% disclosed the costs. Basically, they skipped right over the parts that say you might be throwing up as you are going bankrupt... but I digress.

Emotion based advertising is a key target in the advertising world. Feel their pain and you can make them open their wallets. But evoking fear of death is kind of creepy. If you don't try this, you WILL die!

"“Clinical advertisements that use emotional appeal uncoupled with information about indications, benefits, risks, or alternatives may lead patients to pursue care that is either unnecessary or unsupported by scientific evidence.”"

The researchers conclude by saying that further research is needed to see if this emotion based, direct to consumer advertising is contributing to the sky rocketing cancer care costs in recent years. (Job security.)  If it is promoting misinformation by omission of key information for consumers and playing on their emotions, its not a great use of the money.

My thought is all this advertising is clearly contributing to pharmaceutical company and medical center bottom lines through additional costs. Which in turn is bumping up their overhead. The kind of advertising that is done is not cheap. So maybe we should just get rid of it - just as we got rid of alcohol and tobacco advertising in the past and their costs would go down, and then our prices. But that would be a pipe dream on our part.

Thursday, May 28, 2015

How much would you pay to heal yourself?

Current pharmaceutical pricing of new cancer drugs are sky rocketing. $100,000 for a new medication designed to extend life by months or weeks is crazy. Here is a very long article on cancer drug pricing and all the issues surrounding it. I say read it, its worth it to get a better understanding of the issues surrounding the high prices.

My few points are:
  • Pharma companies spend billions on research, required testing to meet FDA standards, and then can only expect to reap the benefits through the length of their patent which is ten years.
  • If they lowered prices, their share holders would be unhappy and less likely to fund additional research for new drugs which would result in fewer new drugs in the future even though the short term benefit of reduced pricing would benefit patients. But the shareholders would be happy.
  • In their research process, numerous discoveries do not make it FDA approval and are tossed, throwing out years of research and billions of lost costs.
  • And the most appalling: "The high cost of current cancer therapies is at least limited by the relatively small patient populations they treat.  Next generation immunotherapies, including CTLA-4, PD-1 (programmed cell death), and chimeric antigen receptor therapies (CARTs), appear to deliver much improved outcomes (in some cases including complete remissions) with limited side effects – and may also be used to treat many more cancer types and much larger patient populations than current therapies.  Given their inherent value to patients, they could easily command prices well in excess of $100,000 per course of treatment." Please reread that last sentence: Given their inherent value to patients, they could easily command prices well in excess of $100,000 per course of treatment.
I can accept that lots of research can end up in the trash bin if drugs do not perform as expected. I can buy that happy, rich, healthy share holders help companies stay on track. But I cannot and will not accept pricing based on the 'inherent value to patients'. That is basically saying that they are charging what they think a patient would pay.

This is like saying when you break a leg, how much would you pay to have it set and mending with pain under control? At the second of pain, you would probably pay $2000 for that first shot of morphine....

That's insane. Go get some morals and charge patients correctly.

Wednesday, May 6, 2015

The Cost of Cancer Care - or Big Pharma Is Getting Rich

Today's Boston Globe has an article on the "Sky-high drug prices test cancer patients". A few little pieces of information I drew from it:

"In the United States, a month’s supply of a brand-name cancer drug is now about $10,000, double what it was a decade ago, according to the report. The most expensive drug, at $117,648 for a course of treatment, is Bristol-Myers Squibb Co.’s Yervoy, the first drug to prolong survival in patients in advanced stages of the skin cancer melanoma...."

"...On average, an insured patient’s total outlay for a year’s cancer treatment is about $9,000, excluding any assistance programs, with the insurance company covering the remaining $115,000, according to Aitken. Patients receiving older cancer drugs available as generics would pay less.

The higher the patients’ costs, the more likely they are to drop out of treatment before finishing. For example, the report notes that when copayments for hormonal breast cancer treatment exceed $30, there is a 10 percentage point drop in the number of patients who complete therapy, compared with when the copay is $30 or less. For patients who stop therapy and resume it later, the combined patient and insurer costs can jump 50 percent."

$9000 per year is not chump change and the insurance company's share is a paltry $115,000 - so you wonder why insurance companies are feeling the crunch.

But then I found a little article on Pfizer and how generics are hurting Pfizer's profits:

"Despite sharply lower expenses and taxes, Pfizer Inc.’s first-quarter profit dropped 15 percent, due to generic rivals and an end to some promotion efforts with other drug makers. Shares fell as the company missed revenue expectations by $730 million, but narrowly beat profit estimates. Revenue at the New York giant has fallen since 2011 as cheap generics hurt sales of some off-patent drugs that once brought in billions annually, particularly the cholesterol fighter Lipitor, the top-selling drug ever, with peak revenue of nearly $13 billion."

But before you feel sorry for Pfizer at all, their reported net income for the first quarter of 2014 was $2,329,000,000 on $11,353,000,000 reported sales.

So I dug a little more on Pfizer and found this lovely section on the Value of Medicines for Oncology in their Press Kits and Downloads. So I started reading after many self accolades on their benefit to society and was appalled by this section on page 2:

"Based on the average cancer drug expenditure per patient from diagnosis until death over the past decade, an analysis showed that the cost of that added year of life – plus any further benefits to the individual’s quality of living – was about $6,500. Given that surveys indicate that most Americans would be willing to pay $100–$300 thousand to extend their lives by one year, $6,500 represents a bargain for society.
 

For decades, the U.S. public and private sectors have committed substantial resources toward cancer research, but the societal payoff has not been well-understood. One study estimated between 1988 and 2000, life expectancy for cancer patients increased by roughly four years, and the average willingness-to-pay for these survival gains was roughly $322,000. Improvements in cancer survival during this period created 23 million additional life-years and roughly $1.9 trillion of additional social value. The share of value flowing to patients has been rising over time. In terms of economic rates of return, R&D investments against cancer have been a success, particularly from the patient’s point of view."

So they are justifying their high prices of cancer drugs based on the fact that most Americans would be willing to pay huge sums to extend their lives by one year. A bargain for society? So they are getting rich on our wishes not to die? Please. I have no sympathy.

Sunday, January 18, 2015

Going for the heart strings, of course

There was a new study (because we need a new study so the researchers don't have to polish up their CVs -  that's resume for the non-technical) that says there are more and more ads for cancer treatments and cancer treatment centers. Their results showed that:

"A systematic content analysis of these ads found that the content is sharply directed at a would-be patient’s heartstrings:

  – 85% made emotional appeals to consumers
  – 61% used language about hope, extension of life, or a cure
  – 52% touted innovative, or advanced technology or treatments
  – 30% evoked fear by mentioned death, fear, or loss


Nearly half of the advertisements included patient testimonials, but only 15% included a disclaimer about patient outcome. No advertisements described the outcomes a “typical” patient may experience. Failure to disclose this information is a violation of a Federal Trade Commission mandate, the report notes."

Only 2% of the ads disclosed the risks and 5% disclosed the costs. Basically, they skipped right over the parts that say you might be throwing up as you are going bankrupt... but I digress.

Emotion based advertising is a key target in the advertising world. Feel their pain and you can make them open their wallets. But evoking fear of death is kind of creepy. If you don't try this, you WILL die!

"“Clinical advertisements that use emotional appeal uncoupled with information about indications, benefits, risks, or alternatives may lead patients to pursue care that is either unnecessary or unsupported by scientific evidence.”"

The researchers conclude by saying that further research is needed to see if this emotion based, direct to consumer advertising is contributing to the sky rocketing cancer care costs in recent years. (Job security.)  If it is promoting misinformation by omission of key information for consumers and playing on their emotions, its not a great use of the money.

My thought is all this advertising is clearly contributing to pharmaceutical company and medical center bottom lines through additional costs. Which in turn is bumping up their overhead. The kind of advertising that is done is not cheap. So maybe we should just get rid of it - just as we got rid of alcohol and tobacco advertising in the past and their costs would go down, and then our prices. But that would be a pipe dream on our part.

Thursday, January 15, 2015

How much would you pay to heal yourself?

Current pharmaceutical pricing of new cancer drugs are sky rocketing. $100,000 for a new medication designed to extend life by months or weeks is crazy. Here is a very long article on cancer drug pricing and all the issues surrounding it. I say read it, its worth it to get a better understanding of the issues surrounding the high prices.

My few points are:
  • Pharma companies spend billions on research, required testing to meet FDA standards, and then can only expect to reap the benefits through the length of their patent which is ten years.
  • If they lowered prices, their share holders would be unhappy and less likely to fund additional research for new drugs which would result in fewer new drugs in the future even though the short term benefit of reduced pricing would benefit patients. But the shareholders would be happy.
  • In their research process, numerous discoveries do not make it FDA approval and are tossed, throwing out years of research and billions of lost costs.
  • And the most appalling: "The high cost of current cancer therapies is at least limited by the relatively small patient populations they treat.  Next generation immunotherapies, including CTLA-4, PD-1 (programmed cell death), and chimeric antigen receptor therapies (CARTs), appear to deliver much improved outcomes (in some cases including complete remissions) with limited side effects – and may also be used to treat many more cancer types and much larger patient populations than current therapies.  Given their inherent value to patients, they could easily command prices well in excess of $100,000 per course of treatment." Please reread that last sentence: Given their inherent value to patients, they could easily command prices well in excess of $100,000 per course of treatment.
I can accept that lots of research can end up in the trash bin if drugs do not perform as expected. I can buy that happy, rich, healthy share holders help companies stay on track. But I cannot and will not accept pricing based on the 'inherent value to patients'. That is basically saying that they are charging what they think a patient would pay.

This is like saying when you break a leg, how much would you pay to have it set and mending with pain under control? At the second of pain, you would probably pay $2000 for that first shot of morphine....

That's insane. Go get some morals and charge patients correctly.

Tuesday, January 6, 2015

The Cost of Cancer Care - or Big Pharma Is Getting Rich

Today's Boston Globe has an article on the "Sky-high drug prices test cancer patients". A few little pieces of information I drew from it:

"In the United States, a month’s supply of a brand-name cancer drug is now about $10,000, double what it was a decade ago, according to the report. The most expensive drug, at $117,648 for a course of treatment, is Bristol-Myers Squibb Co.’s Yervoy, the first drug to prolong survival in patients in advanced stages of the skin cancer melanoma...."

"...On average, an insured patient’s total outlay for a year’s cancer treatment is about $9,000, excluding any assistance programs, with the insurance company covering the remaining $115,000, according to Aitken. Patients receiving older cancer drugs available as generics would pay less.

The higher the patients’ costs, the more likely they are to drop out of treatment before finishing. For example, the report notes that when copayments for hormonal breast cancer treatment exceed $30, there is a 10 percentage point drop in the number of patients who complete therapy, compared with when the copay is $30 or less. For patients who stop therapy and resume it later, the combined patient and insurer costs can jump 50 percent."

$9000 per year is not chump change and the insurance company's share is a paltry $115,000 - so you wonder why insurance companies are feeling the crunch.

But then I found a little article on Pfizer and how generics are hurting Pfizer's profits:

"Despite sharply lower expenses and taxes, Pfizer Inc.’s first-quarter profit dropped 15 percent, due to generic rivals and an end to some promotion efforts with other drug makers. Shares fell as the company missed revenue expectations by $730 million, but narrowly beat profit estimates. Revenue at the New York giant has fallen since 2011 as cheap generics hurt sales of some off-patent drugs that once brought in billions annually, particularly the cholesterol fighter Lipitor, the top-selling drug ever, with peak revenue of nearly $13 billion."

But before you feel sorry for Pfizer at all, their reported net income for the first quarter of 2014 was $2,329,000,000 on $11,353,000,000 reported sales.

So I dug a little more on Pfizer and found this lovely section on the Value of Medicines for Oncology in their Press Kits and Downloads. So I started reading after many self accolades on their benefit to society and was appalled by this section on page 2:

"Based on the average cancer drug expenditure per patient from diagnosis until death over the past decade, an analysis showed that the cost of that added year of life – plus any further benefits to the individual’s quality of living – was about $6,500. Given that surveys indicate that most Americans would be willing to pay $100–$300 thousand to extend their lives by one year, $6,500 represents a bargain for society.
 

For decades, the U.S. public and private sectors have committed substantial resources toward cancer research, but the societal payoff has not been well-understood. One study estimated between 1988 and 2000, life expectancy for cancer patients increased by roughly four years, and the average willingness-to-pay for these survival gains was roughly $322,000. Improvements in cancer survival during this period created 23 million additional life-years and roughly $1.9 trillion of additional social value. The share of value flowing to patients has been rising over time. In terms of economic rates of return, R&D investments against cancer have been a success, particularly from the patient’s point of view."

So they are justifying their high prices of cancer drugs based on the fact that most Americans would be willing to pay huge sums to extend their lives by one year. A bargain for society? So they are getting rich on our wishes not to die? Please. I have no sympathy.

Thursday, January 1, 2015

And the costs just keep piling up

Back at my first cancer adventure in 1981, my father advised me never to let my Blue Cross health insurance lapse because going forward with a pre-existing condition, I could always lose my health insurance. And that was something I could not afford. For quite a few years, until MA changed the law regarding pre-existing conditions, I would often pay for my own private health insurance to ensure I never lost Blue Cross. Even if my employer was offering another plan, I would pay for my own. That wasn't cheap.

Then I had more medical adventures and got to know the surgery department and ER a few more times. I kept my Blue Cross insurance and kept on paying. From time to time I would have a job which offered Blue Cross insurance. Then the law changed and I could stop that.

In the past 7 years since my second cancer adventure, I average a minimum of 50 doctor appointments each year. We max out our out of pocket coverage each year as well. One year a friend convinced to try to keep track of what insurance paid vs what I paid. No contest. I paid a tiny portion of the hundreds of thousands paid by the insurer.

So I am verification of a new study showing that after cancer, patients face rising costs of health care. All of a sudden you get more doctors and more appointments and everything needs to be checked because of your medical history, blah, blah, blah. And there are all the health issues caused by side effects of treatment that may never go away. The lost productivity costs because you have to go to the (damn) doctor or don't feel well enough to work that day. The list goes on.

But now it looks like a cancer diagnosis is financially as well as emotionally and physically taxing.