60 Minutes story

[Marian1961]

Did you see the story on 60 Minutes tonight re Zaltrap and Avastin? It was, to me, distressing. What in the world is Congress doing?

[NZJay]

http://www.cbsnews.com/news/the-cost-of-cancer-drugs/

Here's a link to the written version. Horrific.

[JDinNC]

I saw it and was shocked.....our government laws on drug pricing is obscene.

[ANDRETEXAS]

Our so-called representatives want to cut our deficit, but are willing to let drug companies charge whatever they want, and let the government pay for it. That will certainly cut into the budget deficits. Can anyone say campaign contribution?????

[rp1954]

Uncle Sam, the monopoly man.
Although unrestrained corporate greed is a problem, it is not the fundamental source of our problems but rather a symptom of poor policies and laws. Part of the pricing problem is a lack of price competition due to (poor and over-)regulation of free speech, drugs and medical practices, and second, uncapped reimbursements with consumers not taking much ownership of treatment and costs from the start. Distraint is a fundamental problem - in the nominal drive to protect the least competent of the public, rights are removed from all, fortifying unreasonable price demands.

If xeloda's oral 5FU competitors had been allowed into the US in the 1970s, 80s or 90s, monthly costs of 5FU-based oral treatments could have been much different these past 15-20 years, where 95-99% lower is easily possible.

If more families really had to pay more of the Avastin bill over a reasonable amount, clinical skills with generic cimetidine, IV vitamin C, celecoxib and other generics might be in more demand if the Avastin charges didn't get more reasonable. Avastin targets VEGF-A. VEGF and other targets can be attacked a variety of ways, but mostly patients only get to choose the easy, FDA approved answers, regardless of cost, comfort or need. If people had to personally pay the full freight, there might be more interest in less expensive alternative means with reasonably justified medical claims.

Likewise, the FDA and medical boards attack any treatment or claims regardless of merit until officially documented and blessed by pretty arcane and venal systems. This greatly impacts the off label use of old drugs, generic foreign drugs and supplements, regardless of merit.

[kbedz]

I feel so uneducated and let's face it, dumb regarding this information. I have no idea how any of this works. I know I should. I know I need to. But even reading the last post makes me feel stupid. And sometimes, when I lie in bed at night and really think about things. Think about the evil in the world and how much needs to be fixed with everything that's wrong, I just can't handle it. I have to remember to take it in little chunks. A day at at time. And handle what I can handle.

I watched with my jaw just hanging most of the time. Geez... I need to get educated.

[Marian1961]

I don't think you have to understand the minutia of it----the interview with the rep from Pharma (lobbying arm of drug companies) pretty much informed----it isn't them, it's insurance companies. I actually laughed out loud, his assumption of our base stupidity. It isn't drug cos or insurance cos. Its Congress. Contact your reps and senators and tell them to do something about it. The story started with the statistic that 1 in 3 Americans will deal with a cancer diagnoses in their lifetime. Pretty sure 1/3rd of us are not being appropriately represented.

[mstults]

I'd be interested in the thoughts of our people here that know the I dusty and know what they are talking about. I don't tend to believe everything I read.

[Redtexa5]

This interview is just crap and stupid crap at that. Not that I don't think that drug companies aren't thieves, but Dr. Pinhead, oh excuse me Dr. Leonard Saltz, has no idea how Medicare actually works. God save me from morons in white coats.

[Voxx66]

Like most 60 minutes stories, I would take what they say with a grain of salt. Most middle class patients ARE eligible for extremely generous subsidies for Avastin. (I have no idea about Zaltrap) Like as in essentially ALL out of pocket costs paid. (All of mine were paid. It was and is cheaper for me to do Avastin than 5fu.) But not if you are on Medicare/Medicaid. That is a law about not allowing incentives by drug companies to patients on these programs and that is something that should be investigated.

But in general I would argue - it isn't just the drug companies, or the insurance industry, or Congress - it's US. The patients. We sometimes fight so desperately that we are willing to pay any price for a slight chance at a small extension of our lives. I think this is understandable but it contributes to the issue. Don't get me wrong: I am all about fighting. But it has to be worth it in terms not only of quantity but also quality and yes - cost.

[ANDRETEXAS]

Patients (cancer or otherwise) who do have agonizing medical and financial decisions to make regarding their health are not allowed to make those because of the influence others (doctors, insurance companies, pharmaceutical companies) have over those decisions. That is a fact. Fairer and more equitable choices should be more prevalent.

[Redtexa5]

But not if you are on Medicare/Medicaid. That is a law about not allowing incentives by drug companies to patients on these programs and that is something that should be investigated.

Voxx I take it you mean "There is a law not allowing..." and if by that you think that people on Medicare can't qualify for patient assistance programs from the drug manufactures, well you are mistaken. I am on three different PAPs and I am on Medicare. As far as, PAPs and Medicaid go can't answer but just doesn't make sense to put someone in a PAP who is on Medicaid for a whole host of reasons that it is far to late to get into.

So Dr. Pinheads argument about patients being bankrupted by covering twenty percent of chemo drug costs is even more ludicrous, although more than likely there medigap or advantage plan would cover the portion of the costs that Medicare didn't cover in one form or fashion. Lots of details in that last statement to that it is just to late to get into.

[Bev G]

Well, here's one thing about Medicare/Medigap. We (DH and I) went on Medicare in November 2103 when his Lymphoma required that he go on disability from his employer. I had already qualified, even though I'm under 65 because of stage IV SSDI but hadn't signed up with Medicare because I had good insurance through his work. He is old enough for Medicare, but likewise hadn't used it because of our private insurance. So, when I called to sign up for Medigap through AARP he was in the hospital for the lymphoma. They would provide us with Part C, butt would NOT cover anything having to do with the hospitalization, or anything he had been treated for in the prior (I think) six months. Unfortunately (or fortunately,, depending upon how one looks at it) he was in the hospital for his bone marrow transplant. It cost an incredible fortune---I guess around several hundred thousand dollars for the whole preparation and actual procedure---at one point I was giving him 6 shots of Neupogen a day for 6 days at $8500 per injection---so just that was $50K per day . That went on for two different weeks. So, maybe the bill is even more than I think.... Anyhow, I've have yet to learn of our total obligation to Dartmouth, but even 20% of that bill will be breathtaking. I can't really stand to think about it very much and try to put it out of my mind for now. He hasn't worked in a year, I still have an unsold house in Pittsburgh, and an incredibly expensive lawsuit going on in Pittsburgh, so, like Scarlett O'Hara, I'll think about the hospital bill tomorrow.. or so.... Also have a husband who is now, miraculously enough, able to return to work as a physician, but refuses to do so. SO, there that is.

Just sayin...not all Medicare co-pays are nothing to worry about.

[Voxx66]

You can't directly qualify for Genentech's Co=pay program if you are on Medicare or any other form of public insurance:

http://www.genentech-access.com/avastin ... -pay-cards

The laws and requirements are complicated but there is a work around apparently in the use of a go-between foundation to help with copays. I don't really understand the complicated legal issues here and why some drug companies seem to be able to offer co-pay assistance directly but I know it works this way with Avastin.

[Voxx66]

Also as this may help some: If you are on Medicare and need help with Avastin co-pays, here is a foundation that you should check out: http://www.panfoundation.org/

I also did some checking on Zaltrap. There is also a patient assistance program available for that but it is far more complicated than the Avastin program. It also states that you must not be eligible for Medicare/Medicaid but with some exception for certain people with Medicare type D coverage. Again - I am not completely sure why the exclusions but I am still researching.