Are some medical treatments too expensive to justify?

lazygal

There's a new cancer drug costing 85,000 per patient being approved. http://www.irishtimes.com/newspaper/ireland/2012/0504/1224315592242.html It doesn't cure the disease apparently, but does offer some help. There's also cases of people being sent to other countries to avail of expensive treatments not available here and the HSE funding it. Is 85,000 for treatment for one person too expensive? Or is life something for which money shouldn't be a factor?

bellylint

It's a horror to turn around and say, we just cant afford to offer you a potential cure, and a least a length to your life. Though on a practical level, limited resources mean you cant practically do everything. I would rather see the resources for cost of the 100 odd people who receive this treatment, instead go to buy guardasil to start up the cervical smear vaccination programme.

pickarooney

Ideally, no. Realistically, yes - the money to pay for it has to come from somewhere else and it's likely several people will die as a result of saving one. I wouldn't like to be the one trying to explain that to a dying patient though.

smash

The sad thing is that there is no possible way it should cost anywhere near €85,000.

Seachmall

I have an opinion on whether or not it's justifiable, but I'd feel bad if I expressed it.

Take from that what you will.

CardBordWindow

The Research and Development involved to create these drugs probably cost a lot, but the manufacture and distribution costs are probably very low.
The only winners from charging 85,000 are the pharmaceutical companies, the majority of which operate tax-free!

Dravokivich

85,000 euro for something that doesn't do the job?

excuse my french but...

THE FÚCK!?

Winston Payne

Seachmall wrote: »

I have an opinion on whether or not it's justifiable, but I'd feel bad if I expressed it.

Take from that what you will.

It's After Hours, live a little.

Penny Dreadful

CardBordWindow wrote: »

The Research and Development involved to create these drugs probably cost a lot, but the manufacture and distribution costs are probably very low.
The only winners from charging 85,000 are the pharmaceutical companies, the majority of which operate tax-free!

The R&D costs a whole lot of money. The drugs are in trials for approx 7 years before they are widely available and these trials involve a lot of time, staff, resources, equipment, all money whatever way you look at it.
Right now the drugs cost that much but once its widely available other generic versions of the drug will become available at a cheaper price and so in time it will cost less.
The companies are there to make a profit ultimately.

Monty Burnz

Penny Dreadful wrote: »

The R&D costs a whole lot of money. The drugs are in trials for approx 7 years before they are widely available and these trials involve a lot of time, staff, resources, equipment, all money whatever way you look at it.
Right now the drugs cost that much but once its widely available other generic versions of the drug will become available at a cheaper price and so in time it will cost less.
The companies are there to make a profit ultimately.

Indeed. Why would any drug research happen at all if there was no profit motive?

Here's a list of all successful state drug companies:

End of list.

Jezek

eer..sorry to poop on your AH party, but they negotiated the price and markedly brought it down. So no, it's not 85 000.

CreepingDeath

lazygal wrote: »

There's a new cancer drug costing 85,000 per patient being approved..... Is 85,000 for treatment for one person too expensive? Or is life something for which money shouldn't be a factor?

If it doesn't solve the problem and only gives patients a couple of more months, I'd say it isn't worth it, except maybe in exceptional cases eg. keeping a pregnant woman alive long enough to give birth.

If it had a chance of curing the cancer, that would be a different story.
But there's no claims that it's anything other than a glorified treatment for the symptoms but not the condition.

Also a factor in this should be the patients age, where old people near the end of their expected lifespan shouldn't expect expensive treatments.

wilkie2006

Penny Dreadful wrote: »

The R&D costs a whole lot of money. The drugs are in trials for approx 7 years before they are widely available and these trials involve a lot of time, staff, resources, equipment, all money whatever way you look at it.
Right now the drugs cost that much but once its widely available other generic versions of the drug will become available at a cheaper price and so in time it will cost less.
The companies are there to make a profit ultimately.

Basically correct. Clinical trials actually last between 10-15 years (in the UK anyway). The pharma companies only have a 20 year patent on any drug before competitors can produce generic versions. Therefore, they need to recoup their costs quickly (and these costs can be fantastic... a colleague once told me that only 1 in 20,000 drugs actually makes it to market).

Some interesting stuff about drug licensing: http://cancerhelp.cancerresearchuk.org/about-cancer/cancer-questions/how-are-drugs-licensed-in-the-uk#mhra

and clinical trials etc...

http://cancerhelp.cancerresearchuk.org/about-cancer/cancer-questions/how-long-does-it-take-for-a-new-drug-to-go-through-clinical-trials
The phases of clinical trials

There are 3 main phases of clinical trials. All new drugs have to go through the phases before they can be licensed and prescribed for patients

• Phase 1 trials recruit a small number of patients (up to about 30) to try to find out about drug side effects and the best dose to give
• Phase 2 trials recruit more patients (up to about 50) and look at the effect the drug has on different types of cancer
• Phase 3 trials are much bigger (100s or even 1000s of patients), and compare new treatments to the standard treatments to see which is better

Although many drugs or products start life in phase 1 trials, they don’t all get as far as phase 3 trials and the licensing process.
There are also phase 4 trials. These are carried out after a drug has a license. They aim to find out more about the longer term risks and benefits. And they also want to find out how well the drug works when it is used more widely. There is information about the drug licensing process in our section of questions and answers – choose treatment from the dropdown menu. There is also information about phases of trials on CancerHelp UK.

mawk

yeah, at the moment the cost to get a treatment from idea to market is 750 million euro. and that is increasing fast, the companies NEED to charge a lot to recoup losses. if they don't, they go under and then there is no new medicine and everything stagnates.

Stiffler2

We all know they found the cure for cancer a few years ago but that they can make more monies selling you the treatment.

If they cured you how would they make their monies.



watched a very cool doc a while ago in relation to cancer.
Basically all the chemicals they spray on food, additives, mobile phone radiation / masts is where cancer comes from.

rewind to 100 years ago when this technology did not exist and cancer also did not exist.

28064212

Stiffler2 wrote: »

We all know they found the cure for cancer a few years ago but that they can make more monies selling you the treatment.

If they cured you how would they make their monies.



watched a very cool doc a while ago in relation to cancer.
Basically all the chemicals they spray on food, additives, mobile phone radiation / masts is where cancer comes from.

rewind to 100 years ago when this technology did not exist and cancer also did not exist.

There aren't enough rolleyes in the world

http://en.wikipedia.org/wiki/Cancer#History

c_man

28064212 wrote: »

There aren't enough rolleyes in the world

http://en.wikipedia.org/wiki/Cancer#History

Facts schmacts.

smash

Stiffler2 wrote: »

We all know they found the cure for cancer a few years ago

Yea, with the hundreds of types of cancer there is, they found 1 cure to cure them all.

Your trolling is getting worse.

Clareman

Stiffler2 wrote: »

rewind to 100 years ago when this technology did not exist and cancer also did not exist.

Rewind to a time with an average life expectancy of 49.3 for women and compare it to now with an average life expectancy of 82.6.

Give me some of that wonderful technology people it's killing us slower than not having, the b@stards

I Heart Internet

Not commenting on any particular drug or treatment.

The discussion (heard it this morning on the radio) goes along the lines of "so you're going to refuse people potentially lifesaving treatment because of money?"

The thing that people sometimes miss is that its not money for money's sake. If Patient A can't have a €100,000 treatment then 100 Patients might get say a colonoscopy to diagnose a potential problem.

In fairness, a bigger issue arises when Patient A can't get a treatment but 100 HSE staff get new desks and chairs (for EXAMPLE).

Stiffler2

smash wrote: »

Yea, with the hundreds of types of cancer there is, they found 1 cure to cure them all.

Your trolling is getting worse.

All my posts are Fact





F.A.C.T

lazygal

Stiffler2 wrote: »

All my posts are Fact





F.A.C.T

I think you've misspelled F.A.C.T in this context, it's actually spelled T.O.T.AL. B.U.L.L.S.H.I.T.

Stiffler2

I'll have to refer you to this post :

http://www.boards.ie/vbulletin/showthread.php?p=78499068&posted=1#post78499068

please send me your address....

mconigol

Stiffler2 wrote: »

All my posts are Fact





F.A.C.T

Cancer isn't one specific disease. Run along now and stop talking nonsense like a good lad.

wilkie2006

I Heart Internet wrote: »

In fairness, a bigger issue arises when Patient A can't get a treatment but 100 HSE staff get new desks and chairs (for EXAMPLE).

Yea, but that type of argument (and I understand you're only using it hypothetically) is usually just sensationalist, tabloid rubbish that ignores the bigger picture.

In an instance where that argument is cited, there may be two facts:

1. patient refused treatment
2. HSE staff get new office equipment

However, there's no correlation between the two; funding for 1 and 2 were to come from different purses anyway.

FYI - in the UK - the MHRA decides what drugs should receive a license (based on safety and efficacy) but NICE decide whether these licenced drugs represent value (based on financial considerations) and if they should be available to NHS patients. The Dept of Health has nothing to do with it. If the drugs/treatments are licenced (by MHRA) and sanctioned for NHS use (by NICE) then they can be prescribed.

Capt'n Midnight

Penny Dreadful wrote: »

The R&D costs a whole lot of money.

It's nearly half what they spend on marketing

And the main customer is the health sector and technically speaking the main selling point should be peer reviewed results so drugs should cost an awful lot less.

http://www.sciencedaily.com/releases/2008/01/080105140107.htm

http://www.theatlantic.com/business/archive/2009/07/r-d-v-marketing-where-should-drug-companies-spend/20846/

Looking over the past thirty years of drug company annual reports (and stock prices), they find that the "sales, general, and administrative" category went up slightly (as a per cent of total sales) in the 1975-2006 period, from 32% to 39%. Interestingly, manufacturing and general cost-of-goods was the leading expenditure in 1975 (43%), but this has gone down pretty steadily to about 23%. And even more interestingly, the percent spent on R&D has more than tripled over the same period, from 5% to 17%

Ficheall

Does the OP's question relate to medical treatments the HSE pays for, or treatments in general?
If I had cancer and there was some (good) treatment which cost 85k, I would come up with the money and have the treatment. As such, I would feel that the treatment should be made available.
If the HSE were to pay for it, however, health insurance costs would go through the roof, and just think of the complaints we would have about medical card holders and dole scroungers then...

trishasaffron

OP - I think the basic question here is of huge significance and we are very ill equipped to deal with it as a society. If any particular sad story makes the headlines - through good marketing or whatever - the public response is "send to child on the government jet to have their ... ......... at any cost" "keep the 98 year old woman alive" and no debate is possible on the opportunity cost of doing so. e.g. if you do that then stroke patients will have to wait 2 more hours on trolleys or whatever. No decision to apply funds in a healthcare area is without negative consequences in another area - it is and always will be about choices. Budgets will always have limitations.

Its like we are a childish society only concerned with "what I want now" and no sense of taking responsibility for the choices we must make. Or at least the choices are made by default instead of explicitly because we're too scared or inadequate to do the thinking.

We need to grow up.

Coffeeteasugar

No,and why should a justification be relevant at all. If it's alleviating the individual's illness, all resources should be invested.

shopaholic01

CreepingDeath wrote: »

If it doesn't solve the problem and only gives patients a couple of more months, I'd say it isn't worth it, except maybe in exceptional cases eg. keeping a pregnant woman alive long enough to give birth.

If it had a chance of curing the cancer, that would be a different story.
But there's no claims that it's anything other than a glorified treatment for the symptoms but not the condition.

Also a factor in this should be the patients age, where old people near the end of their expected lifespan shouldn't expect expensive treatments.[/QUOTE]


Easy to say. How would you feel if you were told you had weeks to live? Or someone you were close to? Believeme, in that instance you would gladly beg, borrow or steal for a couple of more months, regardless of age.

Monty Burnz

Capt'n Midnight wrote: »

It's nearly half what they spend on marketing

And the main customer is the health sector and technically speaking the main selling point should be peer reviewed results so drugs should cost an awful lot less.

http://www.sciencedaily.com/releases/2008/01/080105140107.htm

http://www.theatlantic.com/business/archive/2009/07/r-d-v-marketing-where-should-drug-companies-spend/20846/

"Sales, administrative and general" is NOT EQUAL to "marketing". It's the whole ****ing business aside from R&D and manufacturing. Some of Stifler's facepalms belong to you.

forfuxsake

Coffeeteasugar wrote: »

No,and why should a justification be relevant at all. If it's alleviating the individual's illness, all resources should be invested.

I quite agree. I suffer from macropenis(which is a bona fide medical condition). This may seem funny but it is very cumbersome and can be embarrassing, not to mention how difficult it is to get the b1tches out of bed the morning after.

I could have reduction surgery at €1000000 an inch, so for just €25000000 I could lead a normal life.

I asked social welfare for the dosh but all they did was send me a signed picture of Joan Burton, which somewhat remarkably seems to be doing the business.

Monty Burnz

shopaholic01 wrote: »

Easy to say. How would you feel if you were told you had weeks to live? Or someone you were close to? Believeme, in that instance you would gladly beg, borrow or steal for a couple of more months, regardless of age.

So how many life-saving treatments for young people should be cancelled to extend the life of a bed-bound 86 year old by a few months?

Monty Burnz

Coffeeteasugar wrote: »

No,and why should a justification be relevant at all. If it's alleviating the individual's illness, all resources should be invested.

Because obviously we have unlimited resources and no need to tax anyone or divert the spending from education, law and order, or indeed vital treatments for other people... :rolleyes:

3DataModem

Stiffler2 wrote: »

We all know they found the cure for cancer a few years ago but that they can make more monies selling you the treatment.

If they cured you how would they make their monies.



watched a very cool doc a while ago in relation to cancer.
Basically all the chemicals they spray on food, additives, mobile phone radiation / masts is where cancer comes from.

rewind to 100 years ago when this technology did not exist and cancer also did not exist.

Cancer did exist. It was rarer, because people died younger. A LOT younger.

up for anything

CreepingDeath wrote: »

If it doesn't solve the problem and only gives patients a couple of more months, I'd say it isn't worth it, except maybe in exceptional cases eg. keeping a pregnant woman alive long enough to give birth.

If it had a chance of curing the cancer, that would be a different story.
But there's no claims that it's anything other than a glorified treatment for the symptoms but not the condition.

Also a factor in this should be the patients age, where old people near the end of their expected lifespan shouldn't expect expensive treatments.

There is something really wrong with the thinking behind what you've said there. I can't even begin to express what it is. It could be the cold blooded 'long enough' bit. Once she's served her purpose then to hell with her.

Would whether their life was worth extending depend on the usefulness of the person to society? Would it depend on whether they were too young or too old to be of use? What criteria would be used to decide who would live a little longer and who would die?

Capt'n Midnight

Clareman wrote: »

Rewind to a time with an average life expectancy of 49.3 for women and compare it to now with an average life expectancy of 82.6.

Give me some of that wonderful technology people it's killing us slower than not having, the b@stards

The big change has been in life expectancy from birth.

Once you survive childhood thanks to better sanitation, food, vaccines, lower accident rate things don't get that much better.

IIRC life expectancy for a 40 year old has only gone up by 10 years since 1840's (excluding famines and stuff)

forfuxsake

Only last week my aunt died of consumption.:eek::eek:

Clareman

Hasn't it been that due to the availability of more food/vegetables/vitamins etc. etc. for people (parents and children) mean that children are more likely to survive past childhood? Also the fact that information can be shared easier now than ever before that education, and as a result improvements in medicine

Averages never show the true reflection of anything, but I was just trying to make the point that all the sprays/mobile phones masts can be a good thing as well.

shopaholic01

Monty Burnz wrote: »

So how many life-saving treatments for young people should be cancelled to extend the life of a bed-bound 86 year old by a few months?

In an ideal word a choice wouldn't be necessary. I was simply making the point that it is easy to say non-life saving treatment isn't worth the expense. It's different when you/someone you love is dying. Money becomes irrelevant and you would do anything to buy some more time. It's difficult enough to watch someone die, knowing that there is treatment but it's deemed too expensive would be a very bitter pill to swallow.

Monty Burnz

Clareman wrote: »

Averages never show the true reflection of anything, but I was just trying to make the point that all the sprays/mobile phones masts can be a good thing as well.

There's no proof proof whatsoever that mobile phone masts have any health effects at all, but don't let that get in the way of a good story.

Monty Burnz

shopaholic01 wrote: »

In an ideal word a choice wouldn't be necessary. I was simply making the point that it is easy to say non-life saving treatment isn't worth the expense. It's different when you/someone you love is dying. Money becomes irrelevant and you would do anything to buy some more time. It's difficult enough to watch someone die, knowing that there is treatment but it's deemed too expensive would be a very bitter pill to swallow.

Ok, that's a fair point. I'd certainly understand people spending their own money on such treatments, as opposed to limited public money.

trishasaffron

shopaholic01 wrote: »

In an ideal word a choice wouldn't be necessary. I was simply making the point that it is easy to say non-life saving treatment isn't worth the expense. It's different when you/someone you love is dying. Money becomes irrelevant and you would do anything to buy some more time. It's difficult enough to watch someone die, knowing that there is treatment but it's deemed too expensive would be a very bitter pill to swallow.

Perhaps that is how you operate - but adults need to be able to make choices - even very difficult and hard ones.

Clareman

Monty Burnz wrote: »

There's no proof proof whatsoever that mobile phone masts have any health effects at all, but don't let that get in the way of a good story.

I was once asked to support a local group's opposition to a mobile phone mast being erected in the locality, I took a phone, a palm treo and a data card out of my pockets and made it clear that I wanted the mast to be erected and if anyone ever was to prove there was anything wrong with the technology that I'd very interested to read up on it.

Coffeeteasugar

Monty Burnz wrote: »

Because obviously we have unlimited resources and no need to tax anyone or divert the spending from education, law and order, or indeed vital treatments for other people... :rolleyes:

Well obviously I'm aware of such,but shouldn't health be given a priority over more superficial tax paying considerations?I'm certain you'd be thinking the same subsequent to spending a few nights on a hospital trolley in an overcrowded corridor!

shopaholic01

trishasaffron wrote: »

Perhaps that is how you operate - but adults need to be able to make choices - even very difficult and hard ones.

Not being able to afford treatment isn't a choice, it's a reality.
I don't understand what you mean when you say 'perhaps that it how you operate'. Do you wish all sick people to die asap?

Monty Burnz

Coffeeteasugar wrote: »

Well obviously I'm aware of such,but shouldn't health be given a priority over more superficial tax paying considerations?I'm certain you'd be thinking the same subsequent to spending a few nights on a hospital trolley in an overcrowded corridor!

Like education and stuff?

up for anything

shopaholic01 wrote: »

In an ideal word a choice wouldn't be necessary. I was simply making the point that it is easy to say non-life saving treatment isn't worth the expense. It's different when you/someone you love is dying. Money becomes irrelevant and you would do anything to buy some more time. It's difficult enough to watch someone die, knowing that there is treatment but it's deemed too expensive would be a very bitter pill to swallow.

trishasaffron wrote: »

Perhaps that is how you operate - but adults need to be able to make choices - even very difficult and hard ones.

No need to be so patronising. :rolleyes: She/he made a very valid point. I, for one, would be doing whatever lay within my power to extend the life of someone I loved and would understand anybody doing so and support them in whatever way I could and I'm an adult who has made very difficult and hard choices when necessary.

trishasaffron

up for anything wrote: »

No need to be so patronising. :rolleyes: She/he made a very valid point. I, for one, would be doing whatever lay within my power to extend the life of someone I loved and would understand anybody doing so and support them in whatever way I could and I'm an adult who has made very difficult and hard choices when necessary.

Does that mean that you would think it correct to have the state pay for treatment for your loved one utterly regardless to the cost and resultant impact elsewhere ? So for example all funds to be used to secure a few days extra life for your loved one at the cost of closure of more A&Es. Just looking to see if you envisage any limits on the costs to keep your loved one's life extended and if so what might they be? or is it literally the case as you say that you would do "whatever lay within my power to extend the life of someone I loved".

up for anything

trishasaffron wrote: »

Does that mean that you would think it correct to have the state pay for treatment for your loved one utterly regardless to the cost and resultant impact elsewhere ? So for example all funds to be used to secure a few days extra life for your loved one at the cost of closure of more A&Es. Just looking to see if you envisage any limits on the costs to keep your loved one's life extended and if so what might they be? or is it literally the case as you say that you would do "whatever lay within my power to extend the life of someone I loved".

That's a tough one but yes, I'd see ten A&Es closed down to extend the life of one of my children if they were dying but could be given extra time and I'd sell my house (and my extended life children) to keep my mother alive.

Capt'n Midnight

up for anything wrote: »

That's a tough one but yes, I'd see ten A&Es closed down to extend the life of one of my children if they were dying but could be given extra time and I'd sell my house (and my extended life children) to keep my mother alive.

Considering the "Golden Hour" where the sooner you get treatment the more likely you are to live or have lower risks of permanent damage you'd kill a lot of people if you closed any more A&E's