The financial cost of saving a life: should it matter?

conorh91

I had this discussion with some friends earlier and would be interested in some alternative views.

A Meathman was last week denied access to €400,000-per-year life-saving drugs that his doctors have prescribed.

http://www.independent.ie/irish-news/health/couple-appeal-for-hse-to-fund-vital-treatment-30909318.html

His family have commenced an online campaign, as they feel the HSE have effectively put a price on the ill man's life. He has paid taxes all his life and now the family feel the State should fulfill its side of the deal.

I do sympathize with their frustration, nevertheless I'm a bit torn. A world of unlimited resources would be fantastic, but in the meantime, we sadly have to allocate resources in a way that hurts the least amount of people, even if that means that sometimes means witholding treatment.

What do people think? Should life-saving drugs be denied if they cost too much? Can we put a price on life?

Kristopherus

Its the manufacturer of the drug that is holding the HSE to ransom. They could, if they wanted, provide it for nominal cost and make their profit from the resulting goodwill.

Menas

Its a sad case.

400k for this medicine seems way OTT. I guess that is because of high R&D costs and little demand for the drug. But aside from the very few who have medicine costs covered thru private insurance there are few individuals who could afford this.

volchitsa

Kristopherus wrote: »

Its the manufacturer of the drug that is holding the HSE to ransom. They could, if they wanted, provide it for nominal cost and make their profit from the resulting goodwill.

Well, they could, but they probably wouldn't make a profit doing it.

If that is what we want that's the system we need to create. As it is, we expect drugs companies to be profit-making, or to go under, leaving the ones that do make a profit to clean up.

bb1234567

God such a tough decision. If he got the drugs every year and lived until 80 which is average life expectancy he will have cost the state almost 20 million euro :eek:

Amirani

There has to be a financial value assigned to qualitative life years, otherwise the state would be bankrupt.

The Peanut

Kristopherus wrote: »

Its the manufacturer of the drug that is holding the HSE to ransom. They could, if they wanted, provide it for nominal cost and make their profit from the resulting goodwill.

It's not quite as clear cut as this but, in essence, I suppose yes. All pharma companies report back to shareholders. Shareholders do not deal in emotion, they deal in business. Companies will make limited, but typically, well publicised concessions to allow medicines to be distributed to needy causes on very limited bases. This is good for business, good PR. On a regular basis, no. Sadly.

steddyeddy

Kristopherus wrote: »

Its the manufacturer of the drug that is holding the HSE to ransom. They could, if they wanted, provide it for nominal cost and make their profit from the resulting goodwill.

No they couldn't unfortunately. There are generally very good reasons that drugs are expensive. Governments can help by funding orphan drug programmes (funding drugs for relatively rare diseases) or by pumping a lot more money into research. Research could elucidate better drug targets and maybe cheaper drug synthesis pathways. Clinical trials however are likely to remain high.

whupdedo

bb1234567 wrote: »

God such a tough decision. If he got the drugs every year and lived until 80 which is average life expectancy he will have cost the state almyaost 20 million euro :eek:

That's true, but it shouldn't come into it, he has the same right to life as anyone with a medical condition that would be fatal without medical intervention, how much does cancer cost this country annually ?

Or if we're going down the road of medical costs, what about alcoholics who need a liver transplant ? or the alcoholic or heroin addict who needs treatment that's paid for by the state, These people have a choice not to drink or do drugs, but we don't let them die because they are a drain on the state

400000 a year is a paltry sum in a country such as Ireland to keep a man alive, and if that man can work and be a productive member of society after treatment, well better again,

how much money do we waste every year on life long dole scroungers, inept civil servant spongers and extortionate state pensions to undeserving politicians

If we let this man die for the sake of 400000 miserable grand a year we may as well bring in collective euthanasia for the terminally ill, anyone over 80 and the mentally retarded, that would save us billions in the long term

FalconGirl

I'd like to know if I was this sick one day that the state would look after me after paying a lifetime of taxes. You cant put a price on a persons life. Shame on the pharma company.

srsly78

OP unfortunately we live in a world/society with limited resources. The HSE is overburdened, money spent to save that man would mean less money available to save other people. So to flip your question around, why is that man more important than other people? Do other people also not deserve so have their lives saved? If that e400,000 could save the lives of 2 other people then surely the decision is justified.

The only solution to what you propose is to give the HSE an unlimited budget, which for obvious reasons will not happen in any country.

ancapailldorcha

Kristopherus wrote: »

Its the manufacturer of the drug that is holding the HSE to ransom. They could, if they wanted, provide it for nominal cost and make their profit from the resulting goodwill.

Thing is, you're not just paying for that drug. You're paying for drugs that make it all the way to Phase II trials before failing leaving a shortfall that needs to be made up. I've got my gripes with Big Pharma but lazily labelling them as being inherently evil won't help.

mikom

FYI............

Alexion accused of "moral blackmail" in Belgium

In April and May 2013, Alexion was involved in a national controversy in Belgium when media revealed that the government refused to pay for a seven year old boy's treatment on the account that the drug he needed to stay alive, Soliris, was too expensive. The boy's medicine cost 9,000 euros every two weeks.[13] Several politicians stated that the company was attempting to 'blackmail' the government,[14] charges which Alexion denies. On May 4, 2013, the newspaper De Standaard reported that a PR agency working for Alexion had helped the boy's parents communicate their story to the press.[15] This story was confirmed by other news organizations, and it was also reported that the parents had believed their benefactor was a Dutch organization for patients and that the PR agency acted with permission from Alexion.[16][17]

http://en.wikipedia.org/wiki/Alexion_Pharmaceuticals

My name is URL

FalconGirl wrote: »

I'd like to know if I was this sick one day that the state would look after me after paying a lifetime of taxes. You cant put a price on a persons life. Shame on the pharma company.

Society is pretty much based on putting prices on peoples lives.

candy-gal1

I thought the answer here would be pretty obvious, of course theres no price on life and anyone with a fatal illness should be allowed access to the drug/s that will make them better/live longer.

As Ive said before, and I know a lot of people may not agree with me at all on this, but Science should get concentrating on cures for the incureable/hard to cure and hopefully with any luck a live forever or for hundreds of years at years kind of drug for those who would like to partake

conorh91

srsly78 wrote: »

OP unfortunately we live in a world/society with limited resources. The HSE is overburdened, money spent to save that man would mean less money available to save other people. So to flip your question around, why is that man more important than other people? Do other people also not deserve so have their lives saved? If that e400,000 could save the lives of 2 other people then surely the decision is justified.

The only solution to what you propose is to give the HSE an unlimited budget, which for obvious reasons will not happen in any country.

I believe I mentioned that resources are limited, and I didn't propose the HSE giving the man access to the drug.

Ave Sodalis

It shouldn't matter but it does because, for a long time, society has placed more value on little scraps of paper/plastic/whatever its made if these days, and on imaginary figures on a screen than on a life.

Gael23

Normally I would say absolutely No but this case is different where it isn't feas to provide this drug.

mad muffin

Then we spend millions keeping people alive that have no chance of any meaningful recovery or that are at end stage and are in constant agony.

Roger_007

FalconGirl wrote: »

I'd like to know if I was this sick one day that the state would look after me after paying a lifetime of taxes. You cant put a price on a persons life. Shame on the pharma company.

So, the logic of your argument is even if the cost was €400 million a year to provide the treatment, you would still expect it to be provided?

ancapailldorcha

sup_dude wrote: »

It shouldn't matter but it does because, for a long time, society has placed more value on little scraps of paper/plastic/whatever its made if these days, and on imaginary figures on a screen than on a life.

Well, drug discovery is entirely privatised. Also, a drug can perform amazingly well in cell line and animal tests only to be found unsafe, ineffective or both at human testing. There's an expression; "fail early, fail cheap". If you find out at human trials that you've a dud on your hands, that constitutes a waste of time (several years) and a massive dent in your R&D budget which will need recouping.

Kristopherus

volchitsa wrote: »

Well, they could, but they probably wouldn't make a profit doing it.

If that is what we want that's the system we need to create. As it is, we expect drugs companies to be profit-making, or to go under, leaving the ones that do make a profit to clean up.

The Peanut wrote: »

It's not quite as clear cut as this but, in essence, I suppose yes. All pharma companies report back to shareholders. Shareholders do not deal in emotion, they deal in business. Companies will make limited, but typically, well publicised concessions to allow medicines to be distributed to needy causes on very limited bases. This is good for business, good PR. On a regular basis, no. Sadly.

steddyeddy wrote: »

No they couldn't unfortunately. There are generally very good reasons that drugs are expensive. Governments can help by funding orphan drug programmes (funding drugs for relatively rare diseases) or by pumping a lot more money into research. Research could elucidate better drug targets and maybe cheaper drug synthesis pathways. Clinical trials however are likely to remain high.

ancapailldorcha wrote: »

Thing is, you're not just paying for that drug. You're paying for drugs that make it all the way to Phase II trials before failing leaving a shortfall that needs to be made up. I've got my gripes with Big Pharma but lazily labelling them as being inherently evil won't help.

Guys my point is that on this occasion Alexion could be a lot more magnanimous than levying €400,000 on an Irish patient's chance of a decent life. Notwitstanding the risk of setting an unwelcome precedent in their opinion. I'm just suggesting that a decent offer from them would have a more positive result than spending millions on advertising the drug.

Polar Ice

The field of study is called health economics.
http://en.wikipedia.org/wiki/Health_economics

Basically, the state only have X money for healthcare per year.
If you allocate €400,000 for this cause, then you have to withdraw the same funding from elsewhere. They're tough rationalisations that's a part of funding the heathcare system.

whupdedo

ryanf1 wrote: »

Normally I would say absolutely No but this case is different where it isn't feas to provide this drug.

I'd imagine your opinion would change if he was a member of your immediate family

ancapailldorcha

Kristopherus wrote: »

Guys my point is that on this occasion Alexion could be a lot more magnanimous than levying €400,000 on an Irish patient's chance of a decent life. Notwitstanding the risk of setting an unwelcome precedent in their opinion. I'm just suggesting that a decent offer from them would have a more positive result than spending millions on advertising the drug.

Pharma firms spend double on marketing that they do on R&D. Marketing are the people who convince doctors and states that the drug is worth buying so cutting their budget isn't a smart move. If they sell the drug for less, they'll set an unwelcome precedent as you've noted.

Soliris is their only drug meaning that this is the only opportunity for the company's backers to get a return on their investment. Also, since this disease is so rare, they have to charge a fortune to make a profit. This figure will have been carefully calculated as too much will price out some states like Ireland by the look of things.

gordongekko

Kristopherus wrote: »

They could, if they wanted, provide it for nominal cost and make their profit from the resulting goodwill.

I tried paying my mortgage with goodwill. The bank manager told me to f off.

Kristopherus

gordongekko wrote: »

I tried paying my mortgage with goodwill. The bank manager told me to f off.

Maybe his bank was backing Alexion:D:D:D

namloc1980

They've had similar issues in the UK where this drug costs £340k per patient on the NHS. If the powerhouse NHS is unable to negotiate a cheaper rate then the HSE haven't a hope. Linky

conorh91

conorh91 wrote: »

I had this discussion with some friends earlier and would be interested in some alternative views.

A Meathman was last week denied access to €400,000-per-year life-saving drugs that his doctors have prescribed.

http://www.independent.ie/irish-news/health/couple-appeal-for-hse-to-fund-vital-treatment-30909318.html

His family have commenced an online campaign, as they feel the HSE have effectively put a price on the ill man's life. He has paid taxes all his life and now the family feel the State should fulfill its side of the deal.

I do sympathize with their frustration, nevertheless I'm a bit torn. A world of unlimited resources would be fantastic, but in the meantime, we sadly have to allocate resources in a way that hurts the least amount of people, even if that means that sometimes means witholding treatment.

What do people think? Should life-saving drugs be denied if they cost too much? Can we put a price on life?

He is 33 only. So not paid so many taxes.

hjkl

Cut the wages of every TD by just under 2500 per year and this mans life could be saved at no added cost to the state. Doesn't seem like a whole lot when you put it like that.

mikom

Let's call Kenya and see what they think.