How Much is Three Extra Months Worth?

I’m in the middle of a project about the future of cancer care in this country. And you can’t talk about cancer treatment these days without also talking about cost. That’s because cancer drugs are among the most expensive in the world, with several costing more than $100,000 a year. If you have a 20% copayment, that means $20,000 out of your pocket.

Yet most of these drugs extend life just a few months and most have significant side effects.

Let’s take a look at one drug approved this year: Zykadia, indicated for a type of late-stage lung cancer. It costs $13,200 a month, or $158,000 a year. It works exactly the same a drug approved three years earlier for the same type of cancer, Xalkori, which costs about $2,000 a month less (although still pricy at $11,500 a month). In clinical trials, it staved off cancer progression for a median of seven months (meaning half the patients in the trial saw their cancer begin growing again in less than seven months; half in more than seven months).

I’m not saying that an extra seven … Continue Reading

cancer cancer drug cost

What a Lost Passport Taught Me About What’s Really Important

I write this while sitting on the couch in a Residence Inn outside of Washington, DC watching a Soprano Rerun and eating bad Chinese food.

  This is not where I’m supposed to be. I’m supposed to be at a beautiful resort in Cancun with my husband, our three sons, one son’s fiancee, and one son’s “I hope-she’ll-eventually-be-the-fiancee” girlfriend celebrating my 50th birthday.

I decided to do this trip and bring the tribe along because this family is the best thing I’ve ever done. I  could think of nothing better to celebrate  my half century mark than giving a gift to the people I love most in the world to thank them for the gift they’ve given me.

Then last evening, while pulling everything together for the trip, I couldn’t find my passport. I’d used it to renew my driver’s license last week, and as ID at the hotel where we stayed for Christmas. And now it was gone.

We tore the house apart. Nothing. The hotel couldn’t find it. It had vanished. I don’t think I’ve ever felt so powerless in my life.

The kids and husband left early this morning for Mexico. And I tried as hard as … Continue Reading

cancer cancer drug healthcare system; illness

Rational Rationing

Full disclosure: I stole that headline from an article on Pharmalot that triggered this blog. It reported on a New York Times op-ed piece by doctors at Memorial Sloan-Kettering Cancer Center in New York City about why the hospital won’t use the newly approved drug for metastatic colorectal cancer, Zaltrap.

Their reason? The drug is not any better than the currently used treatment, Avastin, and it costs more than twice as much, about $11,000 for a month of treatment.

Rational? Yes. Rationing? No.

It’s not rationing because patients can always go to another hospital and get the drug, which I know they’ll do because in this country we believe “new” is always better in medicine.

I saw this in action when I was a newspaper reporter (remember newspapers? You held them in your hands and got ink on your fingers?). Back in the day, I covered the “bone marrow transplant” story. This was when women with breast cancer demanded  bone marrow transplants even though there was no evidence that this highly toxic, highly dangerous, extremely expensive approach worked. Since the procedure was considered investigative, their insurance companies refused to pay for it. The women sued insurance companies, went to the … Continue Reading

cancer drug healthcare costs Memorial Sloan Kettering rationing Zaltrap