Goodbye 2016, Hello 2017

Looking Back on the Year in Health Care: There Were Some Bright SpotsLooking Back on the Year in Health Care: There Were Some Bright Spots

I don’t know about you, but I personally hate end-of-year columns. I had to write far too many when I was a newspaper reporter (back in the day when you got ink on your hands while reading a newspaper).

So why am I writing one, you ask?

Sigh. Blame it on the young lady who handles my social media. She’s making me.

So here goes.

2016 Highlights in Health Care

There’s a lot of moaning on social media about 2016 and what a terrible year it was. And yes, it did suck for many reasons, none of which I’m going to go into here. Instead, I’m going to talk about a few positives on the health care side for which I’m thankful.

Fewer Uninsured Americans Twenty million previously uninsured Americans now have health insurance. Put another way, the uninsured rate in this country has never been lower. Gains Under the Affordable Care Act Many aspects of the Affordable Care … Continue Reading

ACA Affordable Care Act cancer health insurance

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

Want to Reduce Cancer Deaths? Give Everyone Cancer

I stole that headline from an amazing op-ed in Thursday’s The New York Times written by the co-author of what will likely be one of the most provocative medical studies published in years.

For their study, published online last week in The New England Journal of Medicine, the authors used trend data from the National Health Interview Survey on the proportion of women 40 years of age or older who underwent screening mammography, then compared those numbers against data on breast cancer incidence and survival rate.

They found that 1.5 million more women have received a diagnosis of early-stage breast cancer since the introduction of screening in the 1980s, but there was no change in the number of women with life-threatening metastatic breast cancer. This means that screening, which, as the authors point out, is touted as one of the most important thing women can do for their health and credited with saving millions of women from death from cancer, is neither. Plus, the data they relied on was produced before today’s more advanced mammography techniques, which are capable of picking up even earlier cancers.

So how to explain the drop in breast cancer deaths over the past 30 years … Continue Reading

cancer mammograms

Avastin and Breast Cancer

Time to get back up on my soap box.

Next month, the FDA is supposed to consider taking the unique, first-time-ever step of revoking a drug’s indication not because it’s dangerous, but because it doesn’t work well enough to offset its risks. Never mind that it costs about $8,000 a month.

The drug is Avastin (bevacizumab), a targeted monoclonal antibody that  prevents tumors from creating and maintaining their own blood supply, a process called angiogenesis. Without oxygen and nutrients from blood, tumors can’t keep growing.

Avastin is the world’s best-selling cancer drug, approved for use with chemotherapy to treat lung cancer and metastatic colorectal and breast cancer. It is also being investigated (and, likely, being prescribed off label) for numerous other cancers.

The problem comes with breast cancer. Avastin was approved for breast cancer under an FDA program called “accelerated approval” in which the agency provides “conditional” approval for a life-saving drug that appears effective so as to get it to patients quickly while requiring that the manufacturer conduct more studies demonstrating its long-term effectiveness. About 90 drugs have been approved under the accelerated approval program in the past 20 years and none has ever had its approval revoked (one … Continue Reading

cancer clinical trials cost healthcare costs healthcare reform

Back Away from the Quacks!

breast cancerSo my cousin emailed me the other night. She had a breast cancer recurrence about 6 years ago. Before you feel too sorry for her, however, know this: She’s doing great, moving from one targeted treatment/chemotherapy/laser knife procedure to another. Her doctors are fabulous. Her attitude is amazing. And, as she constantly tells us, she feels great and is loving life. No, this isn’t about her. It’s about her friend, the one she emailed me about.

Her friend was diagnosed with an early stage of an aggressive form of non-small cell lung cancer a year ago. After chemotherapy, a CT scan this summer showed her lungs clear of cancer; but a followup CT scan last week showed some spots. This woman had participated in a clinical trial during her first round of treatment and her doctor wanted her to join another clinical trial. But my cousin’s friend is freaked out; she doesn’t want to feel like a “guinea pig.” So when her daughter suggested she see a doctor who specializes in an unproven and experimental therapy called insulin potentiation therapy, she was ready … Continue Reading

alternative therapy cancer clinical trials quackery