Moral Code?

[Ski Bum]

These sort of immunological therapies hold great promise.  The research and clinical trials involved are anything but cheap.  I personally believe that putting an end to cancer is worth the effort and expense.  

 

The questionable morality comes into the picture when some third party, who is neither health care provider nor patient, impose their values as expressed by what they'll choose to pay for.

 

[MercedesBerater]

True, we all go to work to provide ourselves food and shelter. However, the better the job, the better the food and shelter.

Which is why as a society we have a safety net built in for the lesser among us so they have food and shelter to stay alive.

I think healthcare should fall into that right, as a human. Not as an American.

[ricktate]

Just backs up the fact that the rich live and the poor die.....The only way I got the hep-c drug was to get on the trial test its 1000 bucks a pill.......Rick

[Marvel]

I will try to make this short, but I may wander a bit.

 

My first wife succumbed to Malignant Melanoma on Dec. 28, 2005. Personally, MM is one of the most evil cancers out there and has a very low 5 year survival rate. We, at the time, felt fortunate to try a treatment at the Winship Cancer Center at Emory Uni in Atlanta. The treatment she receieved was IL-2, about the only treatment that showed promise. IL-2 is a modified bilogical/protein treatment. I wouldhave to dig out the cost, but the treatment went basically like this":

 

For five days, they would give you a bag of IL-2 infusion, approx. three times a day. They give you doses until your body can't handle any more. My wife got up to around seven, but was hallucinating a lot. She added about 30 pounds of fluid in the few days she was there. After this, we would travel back home and she would recuperate for the next couple of weeks, losing the fluid, regaining some of her appetite...

 

Then go back to Atlanta and start over. We knew, personally, a couple of patients who went through this regimen and two years after stopping the treament, lesions were still disappearing. For my wife, it didn't help at all. Each dose (infusion) cost about $6k, so each week of being in Atlanta the medicine itself ran to over $40k. This doesn't include all the staff support and use of the facilities. My wife managed to get through 2 rounds, but the MM progression was quite obvious, so the treatment was stopped as being ineffective.

 

My insurance from work was superb, and thinking back, I don't tink we paid over $1k, for treatment that was, on the whole maybe $150k.

 

If the treatment had worked, we probably would have hit the $200k mark and then been done with it, and gotten back to a normal life. She would have seen our youngest finish college (we drove him to school as a freshman and then headed to Atlanta for treatment), seen our oldest daughter and son each get married and enjoyed the grandchildren I now get to enjoy.

 

So what she talked about on a MM forum was this: no one gets out alive. But she also said she wanted to die with Grace, to be obedient to God's will. From the perspective of many, she did that and more.

 

Is the cost worth it? I would say yes.

 

Bruce

[Mallette]

I'll stick to smoking my weed. Been smoking red 100's and weed for 40 years haven't caught cancer yet

 

Many may not know what you are talking about.  The research...anecdotal as well as scientific...in that area is absolutely fascinating.  But, who cares?  It's as good an excuse as any... 

 

Dave

[Mallette]

Is the cost worth it? I would say yes

 

Never added it up,  but the cost of my daughter's wonderful 13 years of life was well over a million dollars.  To ask if it was worth it would be ignorant as best.  I said at the time I'd happily serve in the galleys if it went to keep her happy. 

 

I've nothing but praise for Cook Children's in Fort Worth and Texas Children's in Houston.  We were called "frequent fliers" by staff, given codes to the snack rooms, and supported as if on wings of angels.

 

Dave

[Travis In Austin]

Just backs up the fact that the rich live and the poor die.....The only way I got the hep-c drug was to get on the trial test its 1000 bucks a pill.......Rick

I am really glad you got it Rick. A judge friend of mine had to do interferon, at the time that was all that was available.

The very rich can obviously get any drug, Bart Star was just in Mexico getting a treatment, or the very poor if it is approved by medicade.

What is immoral is that we don't allow Medicare to negotiate with drug companies. Think about that.

We all pay for the cost of these drugs.

"Matt Salo, executive director of the National Association of Medicaid Directors, said competition from Viekira Pak has enabled states to win bigger rebates from the manufacturers. But Salo says cost remains a "major, major problem" because of the large number of people with hepatitis C. At the median discounted price, a 12-week treatment regimen of Harvoni costs about $98,000.

Even with discounts of more than 40 percent, the VA says hepatitis C drugs are contributing to a budget shortfall. The agency asked Congress on Monday for up to $500 million from a new overhaul law to pay for unanticipated costs of treating the disease."

That was a report from this past July.

[derrickdj1]

First, this is a new drug that has taken years to develop.  It is being used to treat lung cancer and melanoma.  Cure rates, or extension of life needs to be taken into account.  For example, the extension of life may be only 3-6 months.  How bad are the side effects?  Morals are hard to judge in this type of scenario, because we don't know how much R&D cost.  Let the drug be used in the general population for awhile.  Things that did not come out in the clinical trials will emerge and we can get a sense of how good this Opdivo is and treating these two cancers.  With widespread use, the cost will come down at some point.

Edited November 19, 2015 by derrickdj1

[Travis In Austin]

First, this is a new drug that has taken years to develop. It is being used to treat lung cancer and melanoma. Cure rates, or extension of life needs to be taken into account. For example, the extension of life may be only 3-6 months. How bad are the side effects? Morals are hard to judge in this type of scenario, because we don't know how much R&D cost. Let the drug be used in the general population for awhile. Things that did not come out in the clinical trials will emerge and we can get a sense of how good this Opdivo is and treating these two cancers. With widespread use, the cost will come down at some point.

The R&D cost was less than 400 million.

[Mallette]

The R&D cost was less than 400 million.

 

Couple of bucks each from every tax payer. 

 

Dave

[xxJPMxx]

The R&D cost was less than 400 million.

 

 

 

http://www.cancer.org/cancer/skincancer-melanoma/detailedguide/melanoma-skin-cancer-key-statistics

 

 

So if 73,870 are new melanoma cases for 2015 then that's $5,414 each patient to get their investment back. Now charge double that at $10k and they now have covered R&D plus made $400,000,000. That's just one year, that number of 73,870 will likely increase each year so profits will soar. The price of $225,000 a treatment seems way off to me. 

[Mallette]

The price of $225,000 a treatment seems way off to me.

 

 

Shhh...

 

Dave

[CECAA850]

So if 73,870 are new melanoma cases for 2015 then that's $5,414 each patient to get their investment back. Now charge double that at $10k and they now have covered R&D plus made $400,000,000. That's just one year, that number of 73,870 will likely increase each year so profits will soar. The price of $225,000 a treatment seems way off to me.

 

You're assuming that ALL of them receive treatment.

 

This reminds me of video games that sell for $50.00.  There's maybe a dollar or two in the packaging and disc itself (if that much).

[xxJPMxx]

You're assuming that ALL of them receive treatment.

 

That is correct, in my eyes wouldn't and shouldn't all people receive treatment? But I digress. At their price of $250k a treatment they cover their losses with only 1600 treatments, that's only .02% of the diagnosed population/year.   

Edited November 19, 2015 by xxJPMxx

[CECAA850]

Does this break any moral code? Should it? Discuss.

 

If they believe they that they can charge whatever they want because they have the only effective treatment for a deadly disease then I believe they've crossed the moral line.  The grey area is how you determine what's a fair profit to make post R&D.  If they were selling audio widgets it would be a non issue.  Charge what the market will allow.  Lives don't hang in the balance in that instance.

[oscarsear]

Well it is both better and worse than inferred.  Consider the headwaters of most of medical treatment is basic research paid for via government grants.   In other words the public pays for academia to plow the frontiers of the medical/biological sciences for the underpinnings of this work and industry often comes in and reaps the profits from that work.  Often industry teams with academia providing partial funding for insider access to all of the results.  

 

That said.........  good health care is expensive, very expensive.  In this country we will accept a real estate industry that generates mega$$$ for individuals with little  formal education and lament the salaries of seriously educated souls in many disciplines.  If America feels that healthcare is a right then they had better assume that being and living as healthy as possible is their personal duty.  As it stands now America is not a healthy oriented country which is a huge shame.  

 

In the interim - things are - pretty screwed up...........  and they look to get much worse afore getting any better.  Insofar as neoplastic diseases ~ early diagnosis is the best and least expensive way to a cure.

[Jim Naseum]

Does this break any moral code?  Should it?  Discuss.

 

http://www.wsj.com/articles/fda-approves-bristol-myers-yervoy-opdivo-for-treatment-of-melanoma-1443711746

 

 

35 36 responses above and not a single one addresses your question. Maybe no one knows what you meant?

Edited November 19, 2015 by jo56steph74

[Mallette]

36 responses above and not a single one addresses your question. Maybe no one knows what you meant?

 

I responded that there was inadequate data to judge.

 

Dave

[CECAA850]

 

Does this break any moral code?  Should it?  Discuss.

 

http://www.wsj.com/articles/fda-approves-bristol-myers-yervoy-opdivo-for-treatment-of-melanoma-1443711746

 

 

35 36 responses above and not a single one addresses your question. Maybe no one knows what you meant?

 

 

37

[BigStewMan]

Don't know why cost is so high. Huge cost for little return, so one moral issue belongs to the patient. "Should i drive up premiums for everyone just so i can linger a few more months?" Not to mention the emotional drain on yor loved ones. Kinda selfish in my opinion. Terminal illness...i refuse treatment, just like my Dad did. He wasn't going to put himself and others through emotional turmoil and great expense just for one more year, most likely spent in a hospital.