leo
Owner
Joined: 23 Sep 2004
Posts: 1574
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 Posted: Fri Sep 24, 2004 4:21 pm Post subject: Costliest New Drugs Escape Patient, Insurer Revolt |
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Fri 24 September, 2004 16:44
By Kim Dixon and Ransdell Pierson
CHICAGO/NEW YORK (Reuters) - When it comes to the price tag for the newest biotechology drugs for cancer and other hard-to-treat diseases, the sky is likely to remain the limit, insurers, drugmakers and industry watchers say.
Neither HMOs nor the government-sponsored Medicare program is seriously challenging unprecedented costs for the new drugs, which include rheumatoid arthritis and multiple sclerosis treatments.
While these new drugs now serve only a narrow population, a stream of other pricey biotech medicines will steadily be launched to serve an aging U.S. population. Their toll on insurers and Medicare could then explode.
Among the new breed of drugs are AstraZeneca Plc's $1,700-a-month Iressa pill for lung cancer and Genentech's injectable Avastin for colon cancer at $4,400 a month.
"There's a public perception that if a drug does any good, we're entitled to have it," said Ira Loss, an analyst for independent research firm Washington Analysis. "That means the future costs of providing drugs to the elderly will likely far exceed" Medicare spending forecasts.
ImClone Systems Inc.'s colon cancer drug, Erbitux, commands about $10,000 per month yet has not been shown to prolong the lives of the desperately ill patients for whom it is approved.
Avastin prolonged the lives of colon cancer victims by about five months in clinical trials, while Erbitux only shrank tumors in clinical trials but still provided some hope as a last ditch treatment.
Older drugs have typically been made of chemicals that are easy and relatively inexpensive to mass produce.
Many biotech drugs, however, are laboratory-altered, naturally occurring proteins that are expensive and complicated to produce and must be injected. Even so, their prices have sparked controversy.
BLACKMAIL?
"Companies are charging whatever they want to extend your life a few months; it's like blackmail," said Shaojing Tong, a Mehta Partners analyst who predicted the government may eventually intervene to force down prices.
Tong said insurers are also facing costs of up to $20,000 a year for new injectable treatments for rheumatoid arthritis, including Amgen Inc.'s Enbrel and Johnson & Johnson's Remicade.
One of the most promising cancer drugs in development is Tarceva, an OSI Pharmaceuticals pill found to extend the lives of lung cancer patients by two months in clinical trials, and to lengthen the lives of patients with pancreatic cancer by two weeks.
OSI Chief Executive Colin Goddard said Tarceva's price will likely mirror that of similar therapies on the market, such as Novartis' leukemia treatment Gleevec, which carries a $2,200 monthly price tag.
"We have to measure these drugs' benefit to society against how we spend money on other things," Goddard said, addressing the healthcare system's ability to bear such costs.
Medicare, the federal health plan for the elderly and disabled, is covering most of these new drugs. As the biggest buyer of pharmaceuticals, it spends $5 billion a year on drugs, most of them injectable ones.
NO BALKING -- YET
The new treatments haven't broken the bank yet because they are still used by a limited number of patients.
"The question of covering Gleevec and Avastin and Erbitux is certainly going to get people's attention and this is going to be a real Medicare budget issue," said Len Lichtenfeld, deputy chief medical officer at the American Cancer Society.
Private insurers do not yet appear to be balking at reimbursement either, mindful that consumers expect access to drugs that provide hope regardless of the cost.
But they are not happy about it.
"When a patient gets a $1,000 (treatment) for a $20 co-payment, that is something that concerns us," said Winston Wong, chief pharmacy officer at CareFirst, a Blue Cross Blue Shield plan in Maryland with 3.2 million members.
Many of these treatments are so new it remains unclear what their real benefits may be. And perhaps much more study needs to be done to correctly identify and target just which patients are likely to be helped by them as a way of curtailing soaring costs to the healthcare system.
But for now, says William Fleming, chief pharmacy officer for Humana Inc., in many cases, "we are going on hope." |
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freeio
Senior User
Joined: 20 Dec 2004
Posts: 116
Location: Guntersville, Alabama
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| Posted: Mon Dec 20, 2004 7:06 pm Post subject: Costly as opposed to what? |
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I am currently undergoing chemtherapy using a Roche product called Xeloda (capecitabine). One cycle of treatments (28 treatment days) costs just about $2200, which does seem awfully high. Note, however, that this is orally administered, as opposed to the 5-FU based drugs it replaces, which had to be infused using a daily IV.
In this case, it turns out that a costly orally-administered drug costs less overall than one which must be infused, even if the infused drug were available for free. Infusion is a costly process, in both time and hospital resources, and that cost has been eliminated.
Certainly, I would prefer that the Xeloda were inexpensive. The shocked look on the young pharmacist's face when the bill topped $2000 was amusing to see, as seemingly no one can just pay such prices. And yet what is the alternative? I do not have a co-payment based insurance plan, and so I see the full costs at the time of purchase. I suppose that I could just not be treated, which it would seem that the insurance industry would prefer. However, since I intend to survive this bout with cancer, after paying the hospital, surgeon, and associated folks $75,000 to cut the tumor out, failing to pay the $6,600 for the final pill bill to make sure it doesn't come back would seem irrational.
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whipple procedure, Oct. 21, 2004
28 days of radiation
56 days of Chemo using Xeloda
diagnosed as progressive recurrent pancreatic adenocarcinoma (Stage IV) Jun. 20, 2006
was treated with gemcitabine, oxaliplatin, and tarceva, which all failed.
Cancer blog: http://diehlmartin.com/cancer.html |
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