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

conorh91

Raging_Ninja wrote: »

There's always been a price placed on a life. In the NHS, thats £30000* - if your treatment costs more than that, then you are depriving somebody else of their treatment. Its the same story here.

* http://www.ncbi.nlm.nih.gov/pubmed/18767894

Interesting article. I read up a little on NICE, the agency that advises the UK Government on the therapies that are best for NHS patients, and how resources should be allocated. I notice that their deliberations must be held in public, and there is significant public consultation.

I wonder who makes the decisions in Ireland? And how? It's important that health spending decisions should be transparent, and reflect public opinion to some extent. I'm not aware of us having any such committee, but we probably should.

gctest50

stillalive88 wrote: »

400 THOUSANDS per year? Are we joking? Do they really want us to believe that it can get THAT expensive? The price is just made up!
What are they healing him with anyways, solid gold encrusted with diamonds?

It's the only thing they sell afaik , they have 1774 - ish employees

1774 need to be paid , they hardly work for the craic ?

company is there to make money , probably not for the fun of it

Kurtosis

conorh91 wrote: »

Interesting article. I read up a little on NICE, the agency that advises the UK Government on the therapies that are best for NHS patients, and how resources should be allocated. I notice that their deliberations must be held in public, and there is significant public consultation.

I wonder who makes the decisions in Ireland? And how? It's important that health spending decisions should be transparent, and reflect public opinion to some extent. I'm not aware of us having any such committee, but we probably should.

We have the National Centre for Pharmacoeconomics who fulfil this role.

Skylinehead

Mr. Incognito wrote: »

There are ten people in Ireland with this disease so the argument that it would bankrupt the state to provide this for everyone is moot.

The treatment should be funded. The deal is terminal patients get free drugs.

Cost shouldnt be a factor.

Pay for the treatment HSE and shut the hell up.

So what parts of the HSE should lose the 4 million a year? It's horrible, but realistically it isn't feasible.

Ave Sodalis

ancapailldorcha wrote: »

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.

I agree with this and never said otherwise. My comment extends right down to basic level. It's a pity it costs so much to make drugs that work and therefore cost so much to use them. It's a pity there's so much emphasis on money in the world. But that's the way it is.

twowheelsonly

Skylinehead wrote: »

So what parts of the HSE should lose the 4 million a year? It's horrible, but realistically it isn't feasible.

It's not going to cost 4 million every year. The European Patent runs out in May this year and the US one in 2020/21. This company have apparently pissed off numerous other pharma companies, some of whom will be only too happy to step in and undercut the cr *p out of them.


Edit:
Example : In 1996 'Triple Therapy' (Aids treatment) was $10-15k per person per year. By 2001 Indian generic company Cipla were able to supply the exact same drugs for $350 per person per year which sparked a price war between big pharmas and generic companies leading to the massive reductions in prices worldwide.
IMO the likes of Alexion knows this and is making hay while the sun shines.

Taco Chips

conorh91 wrote: »

Interesting article. I read up a little on NICE, the agency that advises the UK Government on the therapies that are best for NHS patients, and how resources should be allocated. I notice that their deliberations must be held in public, and there is significant public consultation.

I wonder who makes the decisions in Ireland? And how? It's important that health spending decisions should be transparent, and reflect public opinion to some extent. I'm not aware of us having any such committee, but we probably should.

As mentioned we also have the National Centre for Pharmacoeconomics. Many NICE guidelines for treatment are implemented in the HSE also.

NotASheeple

conorh91 wrote: »

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

No it shouldn't matter. if we can bail out and throw money at criminal bankers. Then we should be willing to fund all life saving treatment.

Turtwig

Nobody bats an eyelid when a high spec pc or laptop costs a thousand euro. Yet, an incredibly complex drug should be sold to the needy for smittens.

Sadly there is a cost to life. What's important is that the market is regulated to keep drugs as safe and effective as possible and there's ample opportunity for companies to make a profit and patients reap the benefits at the lowest practical cost.
The complexity of my sentence above should indicate how tricky the ideal balance is to obtain.

As for the guy in the OP. Every sympathies for his position but the HSE shouldn't fund it. He should by all means try to get as much crowd funding as possible.

gctest50

Skylinehead wrote: »

So what parts of the HSE should lose the 4 million a year? It's horrible, but realistically it isn't feasible.

4 million ? the HSE pay more than that out every 3 weeks in compensation

maybe they should try just a little bit more quality

• €64 million in 2011.
• €47 million in 2012.
• €85 million in 2013.

More than €85 million was paid out in damages by the State Claims Agency (SCA) in 2013 following personal injury and third party property damage claims against the HSE,

http://www.medicalindependent.ie/page.aspx?contentid=45320

mikom

Brian Cowen’s ministerial pension stands at €81,088 per year.
Bertie Ahern's ministerial pension stands at €81,140 per year.
Just sayin........

ancapailldorcha

sup_dude wrote: »

I agree with this and never said otherwise. My comment extends right down to basic level. It's a pity it costs so much to make drugs that work and therefore cost so much to use them. It's a pity there's so much emphasis on money in the world. But that's the way it is.

Medicine isn't as straightforward as we'd like, unfortunately.

twowheelsonly wrote: »

Seriously though, the fault lies with Corporate greed. Alexion, the makers of the drug, are worth billions with over 3 billion in nett assets and over 2 billion in total equity. That suggests to me that the R & D is well paid for at this stage.
Estimates of the number of sufferers of this disease are between 10 and 21 thousand between USA and Europe so whilst rare they're not short of customers either considering that the drug is also used to treat another similar disease. IMO the drug could be manufactured and supplied at a far lower cost now but that might upset the shareholders.

Yes, how dare they seek a return on their investment. The company's worth is obviously tied directly to this drug so they need to charge a high price for it. 21,000 people isn't a drop in the ocean when you're talking about 2 countries with a population of over 370 million.

twowheelsonly wrote: »

Would I give it to this patient??
Absolutely, without a shadow of a doubt.

You have access to an infinite pot of cash then wonderful. That chap and his family will be so delighted.

twowheelsonly wrote: »

The long term figures are skewed in any case as once the patent runs out generic replacements will become available, IMO at probably far less than half the price.

Not much good for patients today though. Patents last for a decade.

steddyeddy

penguin88 wrote: »

We have the National Centre for Pharmacoeconomics who fulfil this role.

I attended a lecture they gave once. They do alter their guideline figure if they think a drug will be effective ect.

steddyeddy

Mr. Incognito wrote: »

There are ten people in Ireland with this disease so the argument that it would bankrupt the state to provide this for everyone is moot.

The treatment should be funded. The deal is terminal patients get free drugs.

Cost shouldnt be a factor.

Pay for the treatment HSE and shut the hell up.

You're seriously misunderstanding the economics of the issue.

bjork

Donnielighto wrote: »

It is not 400k, it is 400k a year and a precendent that the state will shell that amount yearly indefinitely. That level of care could be a pplied to thousands of people and would bankrupt the state if it happened. Unfortunately beyond general health staffing and overheads there is a budget for patient treatments and I think it is around 40k max per person for a single issue.

Set precedent? How would this case do that?
There are 10 other people already receiving this medication. What makes them worth the money and not John?

Why don't we stop their treatment too?

Kurtosis

steddyeddy wrote: »

I attended a lecture they gave once. They do alter their guideline figure if they think a drug will be effective ect.

You'd certainly hope all the drugs would be effective to some degree at least! I know what you mean though, there's the guideline figure but if a drug is borderline or above this, they would also consider the overall budget impact and how innovative the drug is (i.e. is this the only treatment available for a condition?) among other things.

conorh91

bjork wrote: »

Set precedent? How would this case do that?

I cant speak for the poster who mentioned this point, but I assume he's referring to the possibility of another person appearing with this condition next year, and two more the year later, and twelve more over the next decade. Why should they, being equal citizens, not be entitled to the same treatment? There is a danger that a refusal to grant them equal access to the drug would be considered an abritrary administrative decision, after some very expensive litigation.

I don't usually like slippery slope arguments, but it may apply here.

There are 10 other people already receiving this medication. What makes them worth the money and not John?

They are on a pilot programme, presumably predicated on clear rules from the outset, using some sort of methodlogy for their eligibility. In that sense, it isn't arbitrary.

But some HSE official sitting at his desk, reading boards.ie, and deciding "yeah I think I'll give this man a chance, just this once" -- that's arbitrary and it generally shouldn't happen unless we're prepared to maintain this access to the drug in future.

NotYourYear20

conorh91 wrote: »

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

No, it should never matter.

twowheelsonly

ancapailldorcha wrote: »

Medicine isn't as straightforward as we'd like, unfortunately.



Yes, how dare they seek a return on their investment. The company's worth is obviously tied directly to this drug so they need to charge a high price for it. 21,000 people isn't a drop in the ocean when you're talking about 2 countries with a population of over 370 million.

There's a return on investment (+profit) and there's sheer corporate greed. This is the latter. Check out the other Pharmas that have already sued them. This is the only drug they sell. Why??? (hint.... no other Pharmas are willing to share anything with them any more



You have access to an infinite pot of cash then wonderful. That chap and his family will be so delighted.

Doesn't need to be an infinite pot of cash. See below....



Not much good for patients today though. Patents last for a decade.

And the European patent for this drug runs out in May this year while the American one is through to 2020/21. Other Pharmas and generic drug manufacturers will be chomping at the bit to get at this one.

A report yesterday tells us that it's costing 300k a year to keep the 3 Dundons in Jail here not including the legal fees for their multitude of frivolous cases. Trade them with Alexion as test crash dummies perhaps??

DeJa VooDoo

twowheelsonly wrote: »

A report yesterday tells us that it's costing 300k a year to keep the 3 Dundons in Jail here not including the legal fees for their multitude of frivolous cases. Trade them with Alexion as test crash dummies perhaps??

How much does a lethal injection cost?
Couple of quid?
I'll administer it for free.

My name is URL

The HSE are going to supply the drugs to those affected

http://www.irishtimes.com/news/health/hse-to-provide-life-saving-soliris-drug-despite-astronomical-cost-1.2091366

Capt'n Midnight

My name is URL wrote: »

The HSE are going to supply the drugs to those affected

http://www.irishtimes.com/news/health/hse-to-provide-life-saving-soliris-drug-despite-astronomical-cost-1.2091366

Great news for the people affected.


But it will eat into the budget for home care packages other medicines and the recruitment of nurses. Cost will be €33m over 5 years

In other news there are 518 people on trolleys and some children are waiting over two years to get an MRI scan
http://www.irishtimes.com/news/health/children-wait-up-to-27-months-for-mri-at-crumlin-1.2088713



But the real winners here are the drug company shareholders.

One eyed Jack

I stand by my original assertion that while I can empathise with these people's suffering, I feel that the costs of the treatment are far too high to be considered a cost effective treatment. That same €33m could have been better utilised in other areas of the healthcare system that are in much greater need of reform.

I feel that due to the Health ministers handling of this issue that it will be an indication to pharmaceutical companies that they can now literally hold governments to ransom and charge as much as they like for necessary treatments, knowing that eventually the government will pay the asking price.

Turtwig

One eyed Jack wrote: »

I stand by my original assertion that while I can empathise with these people's suffering, I feel that the costs of the treatment are far too high to be considered a cost effective treatment. That same €33m could have been better utilised in other areas of the healthcare system that are in much greater need of reform.

I feel that due to the Health ministers handling of this issue that it will be an indication to pharmaceutical companies that they can now literally hold governments to ransom and charge as much as they like for necessary treatments, knowing that eventually the government will pay the asking price.

Yep, it sets a very dangerous precedent and I do have to wonder whether if this was the early years of a government with no election looming whether they'd have granted the costs. €33 million is an awful lot. You'd be hard pressed to find somewhere else where we spend that on less than 10 people in five years.

More luck to the patients though.

RobertKK

Alexion didn't have to develop the drug Soliris, it cost a lot of money to get it to the stage where it could be marketed, a market that is very small.
The price of the drug reflects the cost combined with the small market for the drug.

Companies will avoid rare diseases or new types of treatment if they believe they are not worth it.

The first gene therapy drug on the market costs $1.4 million for the treatment. The UniQure drug treats an ultra rare genetic disease. It treats lipoprotein lipase deficiency, a genetic blood problem.

So the cost of health is going only one way with more and more cures and treatments for rare diseases coming to the market.

RobertKK

Capt'n Midnight wrote: »

Great news for the people affected.


But it will eat into the budget for home care packages other medicines and the recruitment of nurses. Cost will be €33m over 5 years

In other news there are 518 people on trolleys and some children are waiting over two years to get an MRI scan
http://www.irishtimes.com/news/health/children-wait-up-to-27-months-for-mri-at-crumlin-1.2088713



But the real winners here are the drug company shareholders.

Those shareholders take a lot of risks, if you are a shareholder in a company and your main drug fails a let say a phase 2 clinical trial, I have seen some companies lose 80% plus of their share value.
On the other hand I have seen upto 500% rises when good results come in for an area that has an unmet medical need.
It is a high risk/high reward area for investors. Shareholders need some reward for investing in companies so they have the money to develop drugs.
Then the drugs company can do a share offering when cash is running low and collapse the share price...

yipeeeee

Darwinism and natural selection at work.

jahalpin

mikom wrote: »

Brian Cowen’s ministerial pension stands at €81,088 per year.
Bertie Ahern's ministerial pension stands at €81,140 per year.
Just sayin........

What has their pensions got to do with this?

I wouldn't begrudge any politician their pension, they worked hard for years and have had to put up with crap from the public for years

This pension was part of their overall salary package when they were appointed to their jobs and they are fully entitled to it

The cost of this mans treatment is not just the €400k per year for drugs, it would also be the cost of the medical staff and facilities as well as dole\disability payments while he is unable to work

RecordStraight

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.

How would that work exactly?

And why would any company ever spend its own money researching new cures if it couldn't make money the odd time that they succeed? Net result: no new drugs. How many lives would that cost in the long run?

The superficially appealing, populist answer is very often the wrong one.

Calibos

Please tell me the benefit of this drug to the patient goes further than merely saving them having to get a blood transfusion once every 6 weeks which is how it sounded reading one of the newspapers this morning.