A Cancer Drug Shows Promise, at a Price That Many Can't Pay (NYT)

[NashVegas]

Unfuckingbelievable.

Doctors are excited about the prospect of Avastin, a drug already widely used for colon cancer, as a crucial new treatment for breast and lung cancer, too. But doctors are cringing at the price the maker, Genentech, plans to charge for it: about $100,000 a year.

....

Until now, drug makers have typically defended high prices by noting the cost of developing new medicines. But executives at Genentech and its majority owner, Roche, are now using a separate argument — citing the inherent value of life-sustaining therapies.

If society wants the benefits, they say, it must be ready to spend more for treatments like Avastin and another of the company's cancer drugs, Herceptin, which sells for $40,000 a year.

"As we look at Avastin and Herceptin pricing, right now the health economics hold up, and therefore I don't see any reason to be touching them," said William M. Burns, the chief executive of Roche's pharmaceutical division and a member of Genentech's board. "The pressure on society to use strong and good products is there."

Studies show that Avastin can prolong the lives of patients with late-stage breast and lung cancer by several months when the drug is combined with existing therapies.

http://www.nytimes.com/2006/02/15/business/15drug.html

Unfuckingbelievable. $100k for a drug that can extend life by months. Not cure, extend. Not years, months. With these rates, if I were an insurance underwriter OR a cancer patient, I'd tell Roche to stuff it.

[thebigidea]

1. what a surprise this is coming from a "Mr. Burns"

[Warpy]

2. Some people are desperate for those few months

especially if they have young children at home or are trying to tie up their finances so their heirs won't be overwhelmed when they do die. I can't fault anyone for grasping at straws to squeeze an extra few months out of life if they're wondering how their kids are going to function without them or have any other pressing issues to deal with. Or if they just want one last cruise so they can say goodbye to a beautiful world.

What I do have a problem with is the obvious price gouging by an industry that is terrified there will be too few end stage cancer patients out there to justify the cost of bringing this stuff to market, so they've priced it so that there will be too few people who can afford it to justify bringing it to market. It's a classic case of self defeating price gouging, since most insurance companies will balk at paying even the discounted price for that stuff and delay their victim, er patient's treatment until it is too late.

It's not the desperation of the dying that is the issue here. It's the greed of Big Pill.

[rooboy]

5. They will release the drug.

In countries like Australia the government will subsidise the cost of the drug so that people can afford it. So the drug company gets their money - it's just that the taxpayers will foot the bill.

[Mr.Green93]

3. Nationalize the Drugs Companies

We need to put people ahead of profits.

[Auntie Bush]

13. I don't see why we can't CAP profits on companies that the

public and economy depend on like drugs, oil & energy etc. After they reach a healthy predetermined profit...the costs should be dropped accordingly. Fat Chance!

[Vinca]

4. You have no idea how happy I am my tax dollars go to subsidize

pharmaceutical companies and their research and development, especially when I could never afford the drug if I should need it. Between big pharm and big oil it's hard to decide which is greediest.

[still_one]

6. The trials have some issues

http://www.marketwatch.com/News/Story/Story.aspx?guid=%7B00B89D13%2DE052%2D4207%2DA6ED%2D113B483AFE21%7D&source=blq%2Fyhoo&dist=yhoo&siteid=yhoo

The cost of developing drugs is NOT cheap, especially cancer drugs, and many times does not buy very much, but they have to start somewhere for progress to occur. The patient is NOT forced to submit to this treatment. In addition, the trials and studies were done on the most critical patients who were NOT given much of a chance. If the treatment is done at an earlier stage the results might be better

[Dogmudgeon]

7. It's always something

"The drugs aren't fully-enough tested. They are expensive to develop. The companies have to make their money back, poor things. That would be Socialism, and we can't stoop to Socialism! The patients are those with the worst cancer. Maybe a kindly rich person will come along and donate the drugs. And it doesn't matter anyway, because those patients are at Death's door."

Cue the violins.

Now you know why the drug companies put almost as mouch money into ads telling you how wonderful they are as they put into ads for erection pills.

Have you ever been critically ill? Have you ever been in a situation where your life was worth less than the Product? It will change your enthusiasm for Free Enterprise in a big hurry.

--p!

[Ciggies and coffee]

9. That ad money also has the benefit of keeping the media on

A short leash when the topic is the Pharma/Medical industry.

[still_one]

29. Your view is somewhat biased

Merck gave away their drug for river blindness in Africa

Most big pharma have programs to help people who cannot afford many life saving drugs, but it sounds that you resent that they are even in business.

If you want something done, then work toward a national healthcare plan, but to just attack the drug companies as all bad is NOT the answer

It is expensive to develp drugs. It takes a minimum of five to ten years to get a new drug on the market. Who is suppossed to absorb those costs? If you expect the companies NOT to make a profit, then you can also expect the drug companies, and almost every other technology to be done somewhere else. That will be excellent for the job market, NOT

[NashVegas]

8. They Aren't Using Cost As An Argument

They're using the "inherant value" of delaying the inevitable.

[Gormy Cuss]

16. Right. Because there has been too much independent analysis of 'cost'

and who really is paying for that R & D.

"Inherent value"-- what a bunch of tin men.

[supernova]

10. Most people want to live as long as they can

For Roche to base pricing on essentially a 'quality of life' issue, well, its deplorable and immoral.

[mongo5954]

11. Quality of Life is Sometimes All You Get

My wife will start Avastin on Friday. Herceptin has failed after only one year, and Avastin is our last shot at keeping her alive. Her body is not wracked with pain, she's able to get around (sometimes with assistance), and the CURE is out there somewhere. I'll mortgage my friggin house if I have to in order to keep her for a single day more. This drug will be cheaper in a year or two, but I don't have the luxury of time all the healthy 'holier than thou' people have, looking at this from the outside of this terrible disease. My daughter just gave us our 7th grandchild. We'll go out there this Spring and get a look at the new arrival. The joy that will come from this will last a lifetime, no matter how short it might be. That's quality of life. And that's all I've got. Life's worth saving folks. Sometimes it costs more than words typed out from a safe place...

[JusticeForAll]

12. What a nice reply

Good luck to you and her in your fight. Welcome to DU, we need you!

I'm a survivor of cancer (a much less serious type than what it sounds like your wife has). You are in my prayers.

[pitohui]

19. stay strong and thanks for sharing your story

that is a tough one to be going through

what bothers me is that so many don't have the option of mortgaging their home, because they are younger couples and there is not yet any equity in the home -- i've had several friends develop cancer in their 30s, which is why this worries me -- or with we older folk, because if we mortgage the home, spend down all the IRAs etc, then the surviving spouse will be left beggared, my spouse is younger than i am, i can't rightfully ask him to lose everything he has worked for in a lifetime to give me a few more months of life, i would be trading my months for his years or maybe decades, and that's not a fair deal

i had a friend greatly criticized after she died for keeping it secret that she had a diagnosis of inoperable cancer but i think i might well do the same if the only option was a treatment that beggared my family

as you say, you love your life and you are willing to pay any price and do whatever it takes, and i feel my husband would think the same, which would mean i might feel a need to keep a secret even from him until the very end

these high prices put a very unfair pressure on the family and border on extortion in my book

there has to be a better way, chemicals once discovered are just not all that expensive to produce

[supernova]

21. Whoa Whoa Whoa

Back off. First of all, I'm sorry for your terrible situation. You and your wife will be in my thoughts. :hug:

The focus of my ire is not patients such as you and your wife who rightly expect all that they can, but the company that wants to price Avastin so prohibitively for just the reason you state:

I'll mortgage my friggin house if I have to in order to keep her for a single day more.

Roche is charging that much because they think they can. They essentially feed off patients dire cirumstances. That is what I think is immoral.

And before you think I'm some holier than thou, my mother passed away from breast cancer 10 years ago and my sister is a 6-year survivor. Plus I spent four years working at major cancer center with the terminally ill. I myself have way more scars than most people ever have nightmares about getting. Yes, I'm more than qualified to talk about it.

If you ever need to talk, you're welcome to join us in the Lounge. :hi:

[mongo5954]

23. Apologies

I shouldn't have attacked you. I'm sorry. I'm venting from a standpoint of only have had a couple of days to try and deal with a worsening situation. Again, sorry.

I don't want to readily accuse the pharms just yet. I'm sure their research was costly and they are in a business (flame away, but it's a fact). I appreciate the 'compassion' that is being shown in our case. I know our situation is not the only one that is being funded by the pharm, so I want to be careful and not bite the hand that is feeding us.

I wonder if anyone has any figures on what it costs to develop and bring a drug like Avastin onto the market? It's life and death for the people taking it, but it's a business for the developers, and not getting the ROI before the drug has run it's course (1 year for my wife and Herceptin) might prohibit more research for development of the cure, rather than just a few month's repreive.

[Bridget Burke]

26. Genentech is NOT blaming research costs for the high drug prices....

From the article: Until now, drug makers have typically defended high prices by noting the cost of developing new medicines. But executives at Genentech and its majority owner, Roche, are now using a separate argument — citing the inherent value of life-sustaining therapies.

If society wants the benefits, they say, it must be ready to spend more for treatments like Avastin and another of the company's cancer drugs, Herceptin, which sells for $40,000 a year.

"As we look at Avastin and Herceptin pricing, right now the health economics hold up, and therefore I don't see any reason to be touching them," said William M. Burns, the chief executive of Roche's pharmaceutical division and a member of Genentech's board. "The pressure on society to use strong and good products is there."

They are keeping the prices high because they CAN. People who want a few more precious months of life must pay the price; of course, many can't pay. Once the drug is approved for more diagnoses, it will be even more profitable. Profit is #1.

[Emillereid]

14. And I bet those 'extended' last months are miserable!

[kaygore]

25. From first-hand experience

with two parents, they more often are than aren't, but the family feels so helpless and desperate that they'll often try anything.

[Emillereid]

28. Sadly, that's what the BIG PHARMA counts on.

And oncologists too often do treatments they know will not work because they either don't know what else to do -- or to get their 20K or so. As an illustration, Dr. Nicolas Gonzalez in New York uses an alternative, nutrient based cancer therapy that actually shows promise and the NCI is funding a study of his treatment. The study can only use patients with pancreatic cancer -- one of the deadliest -- for which allopathic medicine has little or nothing to offer. In order to do a proper test of his treatment he can only accept patients who have had no chemo or other therapy. But do you think oncologists will refer their pancreatic cancer patients to Dr. Gonzalez -- no they waste the patients time and money on ineffective treatments -- and then complain that alternative techniques are untested!!!

[kaygore]

30. Dr. Gonzales wrote my dad a very nice letter

explaining that the regimen required that he be able to take about 180 pills/nutrients a day.

We were very impressed with not only Dr. Gonzales' results but the research that he based his therapy on.

The other "problem" with Dr. Gonzales' therapy is that a person should really adhere to it for the rest of their lives. It is very healthy and if we all followed it, we probably would see cancer, heart problems, and degenerate and auto-immune diseases reduced by 80 or 90%. However, it is not easy in this society to follow: vegetarian, organic, etc.

[kaygore]

31. Dr. Nicolas Gonzalez

I can't believe I misspelled his name!

[Emillereid]

32. His diet regimen is not exclusively veggie -- he tailors his diet

recommendations individually and by what kind of cancer one has. Some do lots of meat and protein and others more veggies. Gonzalez' treatment is based on the work of Kelly who found that while he did great on a vegetarian diet, his wife all but wasted away on it. I have tried a plant based diet and I gained gobs of weight and have never felt sicker in my life. There are actually some genetic underpinnings that are beginning to explain these differences.

The AP John institute actually recommends diets low in carbs and amino acids that readily turn into sugars since cancer cells metabolize glucose much more efficiently than fats. They recently published a study they did jointly with Johns Hopkins that looks quite promising. Check them out here: http://www.apjohncancerinstitute.org/

[kaygore]

34. Thank you

[pitohui]

15. "many" can't pay? i'd say it's a price "not any" can pay

who can pay $100K a year to stay alive? you don't make that much in an honest job and presumably even if you have cancer, your spouse and child still need to be housed and fed

no insurance co. is going to pick up on an experimental medicine, so even if you're insured, this is not going to happen for you

i'm tired of taxpayer $$$ going to develop cures that will only be offered to the super-rich, the lifespan of the rich is already averaging much longer than the lifespan of the working man, and it comes down to fairness

i would rather see no more cures developed at all than paying more taxes so that someone who looks down on me and despises me can get years more of life that will never be offered to me

i'm serious, it's time to put a foot down on "research" which only subsidizes the rich, oh, maybe the price will drop and trickle down to the poor in a hundred years but we'll all be dead then

[mongo5954]

20. Trust me, I'm not rich...

...but we're starting Avastin on Friday. Many cancer treatment centers can work with the manufacturers to mediate the costs, which helps get their product mainstreamed - and helps to lower the costs. Also, the manufacturers themselves offer the meds free on a compassionate basis for people who don't have any money at all. I don't like the high price of meds, but to take this NYT story as gospel doesn't take into consideration facts that I'm dealing with on a regular basis. My oncologist is going to start administering this drug on Friday, and they've said for me not to worry. They'll work out the payment issues, if any, and won't stick us with the bill. To date they've been 100% good at this. I'm not rich, but I'm not a dummy either. A little footwork and this drug can be obtained.

[NashVegas]

33. Good Luck to You and Yours

I'm sympathetic to your situation, it's just not one that I would choose to place myself in if diagnosed to have no chance of long-term survival, nor one I'd want to be in again if a loved one had the same.

[Yollam]

45. Well in THAT case...

...why on earth would we want to have limits on profit margins for prescription drugs like other western democracies do? You know the countries where Americans go to get their meds for 25%, 20%, 10% of what they cost here? Nah, the "free market" (lol) is working its magic! Most Americans don't earn anymore than your typical Canadian or New Zealander, but we're the ones getting gouged for meds and health care. ENOUGH already. I'm glad you've found a loophole, but it doesn't sound like it would work for most people, and it doesn't excuse that unconscionable price for life-saving medicine.

[FlaGranny]

17. My first reaction -

Blood sucking leeches on the backs of humanity.

[NIGHT TRIPPER]

18. Humans are one of the only species that EAT THEIR OWN-esp their young

their injured, and their helpless...

We need to purge our species of ANY incentive to EXPLOIT !

Then we might more accurately label ourselves as "Human".

[dysfunctional press]

27. that's not necessarily true

in some species, lions for instance, if a new male takes over as "alpha", the offspring of the previous alpha male are killed, and often eaten.

[NIGHT TRIPPER]

41. "one of the only" was my exact wording- and it's very true-unfortunately

and by the way, we are supposed to be at least a notch above "animals" that run on instinct only--aren't we?

I would hope we could use our intellect at least a little bit...

[mefoolonhill]

22. drug - cancer

Where are the right-to-lifers when we need them?

[fishwax]

42. trust your instincts n/t

[kaygore]

24. Genentech gave my dad Tarceva for free

Genentech donated Tarceva for my dad’s stage IV pancreatic cancer. When my dad was diagnosed on June 10, 2005, he was still a full-time, practicing dentist at almost 83 years old! He had always been a believer in alternative therapies, so we tried to get him into the Gonzales program but we were turned down due to Dad's having terrible GERD which nothing seemed to control, but we did try some other alternative approaches. However, the GERD was a major obstacle.

In the end, I think that Dad's quality of life was so bad and the disease was progressing so fast, that he finally agreed to the Tarceva with Gemzar.

I have to admit that the Tarceva did seem to alleviate his terrible pain (once he started on it, he only needed Vicodin occasionally), but his original prognosis was 4 to 6 months at the most and he died October 10--four months.

Frankly, having lost two parents to cancer--Mom to multiple myeloma and Dad to pancreatic—I feel that extending life a few months, given the quality of life at that point, and then charging such exorbitant prices for drugs that only really prolong suffering and humiliation is a crime.

I am grateful that Tarceva eliminated for my dad the terrible pain so often associated with pancreatic; however, they are not marketing it as a pain killer.

Allopathic medicine decries alternative therapies for offering the desperate hope where there is none and for bilking people when they are most vulnerable. How is what Genentech doing any different I ask you!!!???

[jaded_old_cynic]

35. This just breaks my heart.

Currently, my best friend is suffering from extensive small cell lung cancer, and as it is only has a matter of weeks to live. This weekend she fell out of her chair, and was so weak that she couldn't even muster the strength to lift herself back up, so she laid there on the floor for 2 1/2 hours before her boyfriend got home to help her. But she still has hope. If there is something out there that would possibly help her extend her life and her hope, she shouldn't be denied it because she can't afford it. The unbridled greed of the pharmaceutical companies never ceases to amaze me. I would say more, but I am at a loss for words.

[ikojo]

37. I have a co-worker who was diagnosed with small cell

lung cancer last fall. She is also a survivor of breast cancer. She went through chemo and radiation therapy for the past few months. She had a cat scan a couple of weeks ago and was told that the tumor is GONE and there is no cancer in her body. She was told that they are going to do radiation therapy to her brain because the type of cancer she has always metastasizes to the brain.

I wish your friend luck in her treatment.

[jaded_old_cynic]

39. Thank you so much for your kind words.

But i'm afraid my friends' disease has reached the point where the doctors have told her that her chemo treatments have only a 1% chance of being successful. Her last chemo treatment ended up giving her pancreatitis so bad that she was hospitalized for weeks. So the decision was made to stop all chemo treatments since the last one damn near killed her. She still won't give up though. She has more courage than I would have in her situation. I am glad to hear that your co-worker is doing well. I don't want to get morbid, but the same exact thing happened to my friend. Her scan came back clean last year, and she also had her brain radiated, but 2 months later it resurfaced in her lymph nodes. I hope your co-worker is more fortunate.

[ikojo]

40. I think my co-worker is realistic. She is thankful for each

day. One of her sister's in law was diagnosed with small cell lung cancer two weeks after she was and she died approx two weeks ago. That really shocked my co-worker.

[VegasWolf]

36. Bush and Cheney can afford it. nt

[Orrin_73]

38. Welcome to the bizarro world

were the companies make the rules. God help us all.

[fishwax]

43. fuckers

:grr:

[SoCalDem]

44. A sad connection I have to the story..

My cousin's husband was one of the founders of Genentech.. They are gloriously wealthy.. I recall a while back when the kids were small, my aunt said they were remodeling their daughter's room..to the tune of $60K..This was back in the 80's.

Miracle drugs are not the real issue though, when you get right down to it. people every day "decide" to put off going to the doctor because the car needs fixing, they need to pay the rent, the kid needs school books..

Lots of middle class people get diagnosed when there is little to be done, even if something bad is found..

[Peter Frank]

46. Yet another ploy by the drug industry to completely suck patients dry...

...before they die.