How the costs of cancer care negatively impact patients

Pharma Strategy Blog has reached an exciting double milestone today – 500 posts and 100,000 views! Although the blog was started in 2006, most of the posts have been written over the last 18 months on a wide variety of topics from AIDS/HIV to cancer to rare stromal tumours, as well as notes from numerous conferences and observations on diseases, the Pharma industry, mergers & acquisition, industry leaders and even political reform of health care. We hope you have all enjoyed the ride and will continue to do so in 2010. Do keep your suggestions for interesting topics to cover coming in, we're only as good as the readers who share in the experience.

Right now, I'm in New Orleans covering the American Society of hematology meeting, which is one of my favourite annual meetings, and one I've regularly attended for the last 14 years. Just before I headed south I interviewed Dr Mary Ann Burg about the recent survey undertaken by the Association of Social Work (ASOW). The organisation released an important report late last week, describing the financial and emotional impact of the cost of cancer care on patients, caregivers and how social workers can help facilitate and ease the process as part of a multi-factorial team.

What particularly struck me forcefully in the brief discussion with Dr Burg is summarised in this chart below:

The excellent AOSW report also focused on multiple myeloma as an example of what happens to cancer patients going through treatment and how the costs of prescription drugs can have an impact. For example:

This data reminded me very clearly how much more expensive Celgene's Revlimid is compared to Millennium's Velcade (around a third to twice the cost). Myeloma is a big focus at this ASH, as you will see in other posts this week around the new exciting data coming out in lymphomas, leukemias and myeloma.

The report was also poignant given that the WSJ reported this morning that Allos Therapeutics were launching pralatrexate (Folotyn) in PTCL, a rare form of NHL, at a cost of $30,000 per month. To me, that's unconscionable, especially as the drug has only be seen to shrink tumours and not impact overall survival. We'll see how they fare, but I think I would rather die with my dignity intact than face the sort of extreme stress and financial worries described in the excellent ASOW report than even the co-pay would require. It does beg the question of:

What price a life?
What were they thinking?

Part of being a sensible corporate citizen in the pharma industry is recognising that we all have a duty to be fair minded, responsible and caring; greed in it's extreme form at the expense of patients well being is just nauseous and reprehensible.

Here's a rare call for action.

Please read the AOSW information here and digest the full impact of their findings for yourself. This affects all of us, as industry professionals, friends, caregivers, maybe even as a patient. Share it with others, if you blog or Tweet, write something about the report yourself or share this post or the ASOW link.

More on the ASH meeting and more about the AOSW will continue in other posts later this week.

http://profile.typepad.com/ericgarland Ericgarland

The United States has been suffering under delusions of its ability to pay unlimited amounts of cash for the innovations of the pharmaceutical industry. Often you hear the false debate, “At what cost a life?” which is practically designed to be answered, “Anything! Especially if it is me or my family!” And so we have been dragged into a uniquely emotional debate where some clear analysis of economics ought to brought to bear.
The question is not “Should we spend $30,000 per month for one life?” but “Can any nation pay $30,000 per month per patient for the largest generation of old people in the history of the planet? And from where will this economic vitality come?”
To jump into such a philosophical and legal thicket is to be forced to deal in gray areas for the rest of your natural life. Instead of arguing, as I have heard on TV, that US healthcare is superior BECAUSE it pays for $30,000 treatments, you’ll be forced to ask “What is the best treatment we can get within limits?” Then you’re back at economically-sensitive medicine, discussing evidence-based standards of care, balanced budgets. The debate will sound like it does at medical conferences, far beyond the rhetoric of “USA! We’re better because we’re pricey!” It won’t play as well on cable TV, but it will be a better debate.
Time for the adults to step up.
http://profile.typepad.com/maverickny MaverickNY

Nice observations, Eric. I love your rephrasing of the critical question; that’s a very moot point.
People can’t really judge which system is better until they have lived and experienced other systems in the world for themselves. It’s easy to get emotional about these things. To say the US is better without any reference point other than their on worldview is a little naive and limiting at best.
Even if a $30K/month treatment actually cured people of cancer (which this example does not, it only appears to shrink tumours so far), your fundamental question of whether a nation can afford it remains unanswered.
My perspective also comes from one of a broader sensibility… it is this kind of news that gives the industry bad press with consumers and patients who are forced to pay ever increasing amounts for health care, not always with commensurate benefits.
Economically, the price rises currently doing the rounds are unsustainable and unrealistic. Should people be forced to sell their house or go into bankruptcy to afford a treatment that may or may not make a difference?
And we haven’t even begun to factor in the cumulative costs of chronic therapies such as diabetes and alzheimers etc that will increase in prevalence in that aging baby boomer population over the next 10 years.
http://blog.competitivefutures.com/ Eric Garland

Pharmaceutical companies ought to recognize that they too have been part of the bubble. Housing and healthcare have shot ahead of wage growth. When that happens over decades, as it has, the result is the erosion of the middle class, the economic engine of democracy. Any strategy that hinges on unlimited price growth galloping ahead of wages is doomed to fail, probably resulting in collapse, civil disobedience, corporate hate campaigns and similar earthquakes. While “the market may bear” $30,000 a month, that money has to come from somewhere, notably, people. This quandary does not track with the risk they take in their innovations, but that doesn’t mean it’s not reality.