Monday, October 13, 2008

Are we asking the right questions?

I read with interest this article in the Age today regarding the drug Avastin and it's use for metastatic cancer patients.

So far, it has been approved on the PBS for colon and lung cancer, but not other types of cancer.

Now, of course, there is a reason that drugs take time to appear on the PBS - it must be proven (and should be proven) that they are beneficial for the condition they are treating, but I do find one or two things about this concerning:

This first is that there doesn't seem any urgency or pressure from anyone to establish in a timely fashion if there are other applications - in other words, other cancers or conditions - that this medication could or should be subsidised for.

Secondly - and I think this is most important - there needs to be more pressure on the drug manufacturers to drop the exhorbitant prices of these medications.

The argument is that these companies must, somehow, recoup the cost of developing the drugs they market, and these costs are passed on to the consumer.

Which would be fine, if the consumer wasn't a patient. Whose life may depend on access to that drug. And as far as I'm concerned, it is despicable that anyone, anywhere would first think about cost when determining what medical treatment is most appropriate for a life-threatening illness. The very idea makes me somewhat ill.

These drug companies are not short of a dollar. They receive, on top of the disgusting amounts they charge patients for medication, grants from the government.

If anyone should be crying poor, it sure as hell isn't the drug companies.


Michelle said...

This reminds me of one of the medications that I'm currently on. Lamictal is primarily an epilepsy medication and if you get it for that then it is subsidised.

Sadly, given that I'm using it as a mood stabiliser, I don't get it discounted. When I'm finally on the full dose it will cost me approximately $80 per month. This is on top of the other medication I am on (anti-depressants, asthma, thyroid) so all up even with the subsidised medication it costs me about $175 per month. That is also taking into consideration that I am getting the generic brands.

I'm just bloody lucky I've got a full-time job.

daddy dave said...

The problem I have with your position is that the private sector, currently, seems to be doing a pretty fine job of coming up with new medications and treatments.
In other words, capitalism is powering medicine along to new and better places.
While it is tempting to want to regulate and put the screws on the drug companies, there is a danger that this will destroy or impair the current system, and that excessive regulation will simply encourage mediocrity in their research programs.

I have to respond to this comment:
"These drug companies are not short of a dollar."

It's fashionable to bash drug companies, but keep in mind that two months ago, you could have said the same thing about finance companies such as Lehman and AIG, and everyone would have murmured in agreement.

Keri said...

It’s not because it’s fashionable that I wrote this post, Daddy Dave. It’s because at the moment it’s close to home.

I just think that whilst capitalism might be promoting innovation – and I’m certainly not disputing that – what strikes me as truly awful is that patients might be making life-and-death decisions (Or, as in the case of this article, the Doctors) based on cost. The idea sickens me.

Like I said, are we asking the right questions? I don’t know.

daddy dave said...

Hey, I agree. it's a terrible situation for someone to be in.
Unfortunately, we can't make everything in the world right. We can't stop people from getting cancer or dying. Nor can we protect people from having to make terrible life decisions, such as how much to spend on treatment.

We can take heart that new treatments are emerging, even though - right now- they come at great personal sacrifice and that not everyone can afford them. I'm afraid that's what we have to live with.

Vee said...

Hi Found your blog from Stirrup Queens (thank you for your donation )
I agree Keri. Another twist to this is they will not fund the drug even for lung cancer if you haven't had chemotherapy.
My mother who has lung cancer has only ever had radiotherapy. We are thinking she is now too fragile to go through chemo, but if she doesn't she misses out on a drug that may help prolong her life.
I could go on about other scenarious that my husband is going through but I would be here all day :)

Keri said...

Vee, I'm very sorry to hear you're having those problems. You don't need that on top of everything else.

And no problems, I'm more than happy to help.