Who decides which drug is worth the cost?

What would you expect from a drug costing $250,000 in year one of treatment and then $12,500 a month?

My reaction would be “amazing results.” But for a drug you know well from television advertising, that is not the case … depending on your perspective.

In clinical trials this drug extended life by an average of 90 days. In some uses of the drug it was 6-9 months.

One national health plan in another country has decided the cost is too high and will not pay for the drug.

There are some difficult questions here.

img_2173-1Who decides whether society should carry the cost of such medication? Who decides if such limited incremental value is sufficient to warrant approval of such a drug? Why should such a drug be heavily promoted to the public?

Clearly few patients can pay out-of-pocket for such a drug. How does society advocate for these patients, if it should? Many patients using this drug welcome the extra time it provides them (some noting that assume quality of life as well).

Do these types of drugs, many of which are heavily promoted to the public, deserve a blank check? These are the questions that every single-payer system of health care struggles with. The United States would be no different, but you rarely hear that discussion included in the rhetoric. 


1 reply »

  1. I have seen those commercials not knowing the cost of the drug but I have asked the question why is the drug even approved for only 6 more months of life? Society is selfish. Modern medicine and drug companies want you to believe that you MUST LIVE FOREVER even if you go broke. I admit that might be the correct thing to do for some people, but not me. I do not want my wife eating dog food because I wanted to live 90 more days. I have lived a good life in my 54 years, a few more days of living will not change things.

    I have jokingly made a pamphlet for a fake company called Terminal Cruise Lines. The whole premise is to take that $250K and spend it cruising the world on a floating nursing home / cruise ship with all the amenities of a ship and a nursing home. Bring the family along to celebrate your life by eating, drinking, dancing, talking, and visiting various ports of call. When you run out of money, you get a burial at sea.

    One of my doctors told me that I would have people willingly go on this cruise. The point being is death will come no matter what. At what expense and quality of life do you get trying to stay alive a few more months or year while on some of these treatments. Some people will agree that getting chemo is not living. Leaving you spouse totally broke and homeless is not right either.


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