When you're being robbed at gunpoint, the question often asked is, "Your money or your life?" Increasingly, that is the choice cancer patients are being offered.
The cost for many new cancer drugs is almost unbelievable. Herceptin, a drug for breast-cancer patients, costs $3,200 per month. Avastin, for colorectal cancer, can cost $4,400 per month. Rituxan, for non-Hodgkin's lymphoma, runs $13,000 to $25,000 for one cycle of treatment. Revlimid, a newly approved treatment for multiple myeloma, could cost up to $60,000 per year. And Erbitux, for head and neck cancer or colorectal cancer, might exceed $110,000 annually.
Even for people with insurance, these bills are traumatic. Some plans require patients to pay a steep co-payment or a percentage of the total cost. Even 10 percent of such big bills can add up to thousands of dollars.
And no matter how much they raise their premiums, it is hard for insurance companies to keep up with the skyrocketing increases in cancer drug costs. That may be why they do their best to wiggle out of covering "experimental" therapies.
A revolutionary medicine like Avastin that is approved by the Food and Drug Administration for colon cancer may not yet have official approval against ovarian cancer, even though oncologists are prescribing it for this malignancy. Because this is considered an unapproved use, some insurance companies might try to get out of paying for this potentially life-extending therapy.
Anyone without insurance is out of luck. Although some people are poor enough to qualify for company-sponsored assistance, middle-class cancer patients often aren't eligible.
There are 45 million Americans without health insurance. And once you have a diagnosis of cancer, your chances of getting independent insurance drop dramatically. That means that millions are left with astronomical bills for medications they need to survive.
What's behind the enormous cost of cancer medicine?
Two decades ago, we spoke with a drug-company insider. This former executive related a top-level meeting in which the question was raised, "If you found a cure for cancer, what would you charge for it?" The executive who was being grilled admitted that they would almost have to give it away. At that time, pharmaceutical leaders feared they would be seen as unethical if they gouged patients for life-saving medicine.
Those restraints have disappeared. These days, cancer therapies have become the holy grail for profitability. Many new high-tech compounds don't cure people, but they do extend lives. The drugs are more effective and often better tolerated than old-fashioned chemotherapy. A patient who survives an extra 10 years could run up a bill of $1 million.
Drug companies often justify high prices by pointing to the expense of conducting research. No one doubts that developing anti-cancer compounds is expensive. But when a year's treatment tops $100,000 per patient, the industry risks pricing itself out of the market for lifesaving drugs.
Too soon, neither Medicare nor private insurance companies will have money enough to cover these costs, even with higher premiums. If no one can afford these pricey pharmaceuticals, the manufacturers themselves might fall on hard times.
Joe Graedon is a pharmacologist. Teresa Graedon holds a doctorate in medical anthropology and is a nutrition expert. Their syndicated radio show can be heard on public radio. In their column, Joe and Teresa Graedon questions from readers via their Web site: www.PeoplesPharmacy.com.