How could that most cherished ideal of capitalism, the “free market” ever do anyone harm? It’s the magic bullet, after all, according to conservatives, the engine of all progress, the ultimate hope for mankind. If only big government would get out of its way and let the market work its wonders, the world would be a veritable paradise.
Well, here’s how the “free market” works when the lives of cancer patients are at stake, and in particular the lives on non-Hodgin’s Lymphoma patients for which two miracle drugs exist which can save lives, if (and how big an if that is will be demonstrated shortly) those afflicted with this killer disease can get access to them (via the New York Times):
After an hourlong infusion, Linda Stephens, 58, has been cancer-free for seven years. Dan Wheeler, three years. Betsy de Parry, five years. Before treatment, all three had late-stage non-Hodgkin’s lymphoma, a cancer of the immune system, and a grim prognosis.
All three recovered after a single dose of Bexxar or Zevalin, both federally approved drugs for lymphoma. And all three can count themselves as lucky. […]
Non-Hodgkin’s lymphoma is the fifth most common cancer in the United States, with 60,000 new cases and almost 20,000 deaths a year. But fewer than 2,000 patients received Bexxar or Zevalin last year, only about 10 percent of those who are suitable candidates for the drugs.
“Both Zevalin and Bexxar are very good products,” said Dr. Oliver W. Press, a professor at the University of Washington and chairman of the scientific advisory board of the Lymphoma Research Foundation. “It is astounding and disappointing” that they are used so little. The reasons that more patients don’t get these drugs reflect the market-driven forces that can distort medical decisions, Dr. Press and other experts on lymphoma treatment say. A result can be high costs but not necessarily the best care.
Michael Moore, thank you. I doubt the New York Times would have bothered to cover this story until Sicko was released. And this report demonstrates how accurate and timely Sicko has proven to be.
Imagine that there was a magic potion that could save your life from certain death, but before you could get it you had to spin a wheel of fortune, in which only one spot in 10 awarded you the prize of taking the potion and staying alive. It’s horrific to even consider such a hypothetical, true? Yet that is exactly the position in which non-Hodgkin’s Lymphoma patients find themselves, hoping and praying that they will be among the lucky few to be awarded the prize of these drug treatments, a prize that very well could be the difference between their life or their death.
(cont.)
Other, more thoroughly tested lymphoma drugs are preferred as first-line treatments. But doctors often repeatedly prescribe such drugs even after they have lost their effectiveness — and when Bexxar and Zevalin might work better.
One reason is that cancer doctors, or oncologists, have financial incentives to use drugs other than Bexxar and Zevalin, which they are not paid to administer. In addition, using either drug usually requires oncologists to coordinate treatment with academic hospitals, whom the doctors may view as competitors. […]
… Zevalin hit roadblocks immediately. Its five-figure price caused insurers to balk. Further, its radioactivity made some oncologists worry that it might prevent them from giving other treatments later. […]
For most oncologists, infusions of chemotherapy, Rituxan and other drugs are still their primary source of income. […]
Advocates for the drugs worry the companies may stop making them. Biogen Idec said in October that it might shed Zevalin. Although the company continues to manufacture the drug, it no longer actively promotes it. A spokeswoman for Biogen Idec said the company planned to keep making Zevalin and continued to offer technical support to doctors using it. GlaxoSmithKline said it expected to keep making Bexxar.
Patients who have benefited from Bexxar and Zevalin say they cannot understand why the drugs are not more widely used.
Why aren’t these drugs more widely used? There’s a simple answer, really: Because the free market isn’t the solution to every problem. When it comes to health care, the free market may do a dandy job of enhancing the profits of some companies (think the makers of Viagra, for example), but all too often it hinders the treatment of health care patients with serious illnesses, people like you and I. When profit outweighs other considerations in the health care field, people suffer real harm and many die, and they die unnecessarily.
In a world where health care considerations were not influenced in the slightest by market forces, far more than 10% of the people who qualify for Bexxar and Zevalin would have received those drugs. Sadly, we still don’t live in such a world.
To me it makes one wonder when a doctor stops “pushing” one brand and starts pushing another when the Doc..sez their both the same..except the old brand..probably only had a “fully paid” conference at Lake Tahoe, and the new one in Hawill.
Thanks for this essay.
Last October, my 90 year old Mother was diagnosed with leukemia. The oncologist pushed very hard for her to start chemo at his office. When she refused, he basically washed his hands of her, refusing to give her a referral to Hospice. My family doctor provided the referral and Mom has had a Hospice nurse checking on her once a week. Right now, she’s doing ok but every other doctor & nurse I’ve spoken with about her decision has told me that it was the right one and if, at her age and frailty, she had taken chemo she most likely would have died by now. As it is, we take it one day at a time.
I’m sorry for your Mom’s illness, Denim Blue and I hope she is comfortable.
My brother and I just finished moving my mom, who is also 90, out of her second floor seniors apartment. She had fallen three times and broke bones every time. There are no elevators at her complex and we weren’t able to get a downstairs apartment there, as there is a shortage of subsidized housing for seniors here. She discovered that she liked the assisted living center where she was rehabbing from the last broken hip. Its very close to us, the staff is nice and the food is good. Many of her friends are living there. She is happier than I’ve seen her in a couple of years.
Hugs to you and your Mom.
Yesterday her Medicare subsidy ran out. She can stay in her skilled nursing bed until an apartment becomes available, but the cost now jumps to $157 a day. As long as she stays where she is, she is first in line for an apartment, which is much cheaper.
I’m grateful she has found a place she likes that is close by, but sometimes I can’t help but think we are all cash cows to be milked dry at the end of our lives or before, if they can manage it.
Mom is still in her own home. It’s about 3 blocks away and we’re there at least three times a day checking on her. She fell in December, the day after we signed her up for hospice, but fortunately didn’t break anything. The Hospice people are wonderful and tell me that given her diagnosis (only 8% of her bone marrow was normal in October) that there isn’t a 6 month limit. I think I originally posted because I was so angry at the oncologist whose only interest seemed to be in the $$$ from the chemo. The bone marrow biopsy he performed in the office was horribly painful for her and then it was push, push, push to get an appointment to start chemo. And when she decided not to go that route, he announced that then he couldn’t do anything for her. I suspect that it’s doctors like him that are keeping this new treatment from being used more as it won’t provide the continuing cash flow of traditional treatments.
There are some wonderful people in the medical profession. Our family doctor doesn’t bill insurance providers, we have to do it ourselves, but he sets his rates much lower. Another doctor we know is a tireless advocate for universal health care. He works in an ER. Then there are the RN’s, LPN’s and aides who don’t make much money, but make all the difference in a patient’s quality of life. The hospice people near here are very good too.
My anger is directed toward BigCorpMed, BigPharma and the health insurance industry. I’ll never forget the 40 million bonus the Anthem ceo got in 2004. Sounds like your mom’s former oncologist is one of the latter.