Rationing by Lottery and By Ability to Pay
Provenge, a first-of-a-kind therapy approved in April…costs $93,000 a year and extends life by four months, on average, for men with incurable prostate tumors… In addition to the expense, Provenge is in short supply, forcing the first rationing of a cancer drug since Taxol and Taxotere were approved 15 years ago. At the University of Texas M.D. Anderson Cancer Center in Houston, doctors plan a modified lottery to decide which of its 150 or so eligible patients will be among the two a month it can treat with Provenge. An insurance pre-check is part of the process to ensure they financially qualify for treatment [emphasis added].
Full article on how much a few more months of life are worth.
Let’s see how many different ways are there to ration care? By age? Height? Weight? IQ?
Ken, I don’t know how many ways there are, but I have a feeling that in the next few years we are going to find out.
You neglected to mention that the article interviews a patient who says he wouldn’t buy the drug if he were spending his own money. He is using the drug only because his medigap policy pays for it.
From a societal viewpoint, it may not be worth $93,000 of taxpayers’ money to extend the life of a Medicare patient by four months. That is more than double the rule of thumb (for the value of one year of life) I was taught in cost-benefit analysis.
However, drug developers will tell you advancements in research are incremental. For instance, Provenge is a steppingstone to the development of other drugs; learning how to administer it and the most successful combination of cencer drugs advances the science of cancer care.
In the future, the most promising cancer drugs will be combinations that attack cancer from different pathways — just as AIDs drugs are most successful when administered in cocktails. If we don’t develop and test promising drug therapies merely because they are not “home runs” by themselves, we will never find therapies that are home runs.
John, do you think Pelosi, Reid, Sebelius and Obama are going to have their care rationed? Fat chance.
Tom,
Do you think Bush, Cheney, Rumsfeld, and Wolfowitz, are going have their care rationed? Fat chance.
See how ridiculous this looks?