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November 25, 2009
Evaluating the costs, benefits of new cancer-fighting drugs

In Wednesday’s show, we look at a new cancer drug, Avastin, which can reportedly extend patients’ lives. So just how much medical care should be made available to patients at the end of their lives?

Henry Aaron, a senior fellow and noted health care expert with the Brookings Institution in Washington DC, joins Martin Savidge to discuss the issue.

Tell Us What You Think:

In an effort to bring down healthcare costs, should the U.S. government limit payment for cancer-fighting drugs that only extend life by a few months?

Please remember to be respectful and on-point in your comments. Malicious or offensive comments will be deleted and repeat offenders will be banned.

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Comments

25 comments

#25

I’m 68 yrs old, so I have an immediate interest. I have very good medical insurance. I say NO to prolonging my life & I’ve told my family that over over again, just in case they don’t get it.

#24

yes, we should limit their “use”,if you can call it that. If doctors/practitioners are honest about the prognosis , side-effects, etc there is still time to plan and adjust with family. We must end the selfishness and be honest, not false hope for us and the family and friends. I am 61. Think of the future generations. We elderly are bankrupting their medical future. Pay from your pocket, not theirs or face life and death as part of the same process.

#23

Lyna Hinkel Says,”Such blatant Agism is nothing new.”

Here is the point that Lyna and many others seem to have missed: If you get to the end of your life, and you would rather pay $50,000 for drug that extends your life for (say) two months, it is your right to do it. Nothing is stopping you (or a relative) from selling your house and using the money to extend your life a month or maybe three. Lyna is asking is asking that other people, people who do not want to end their own days in an ICU with strangers, pay for what she wants. This is a democracy. We have money for whatever we want. If Lyna can convince a majority of people to vote for paying for drugs that cost $50,000 and do little or nothing, it is going to happen. The question is, after we all pay our share of those taxes, will we have anything left educate our kids? In England, they pay 40% of what we pay, and they get medical care that covers every single person, to an extent that people in England are aware of and generally approve of. If a family of four in the USA paid $600 per month (Netherland rates) instead of $1200 per month (USA rates), they could bank the difference, retire as millionaires and buy any medicine the want.

And don’t say that is only what they rich could do, that is subject of tax policy. If we make sure to share the benefit, than everyone can do it. If you want to be in an ICU with needles in you arms when you die, good luck and God bless you. I want to die in a garden watching a hummingbird or a hedgehog, or in a chair with my favorite dog sleeping next to me.

#22

Well said rich. Like all our resources, medical treatment is limited. We need to make smart, objective decisions about how it is used.

#21

Such blatant Agism is nothing new, but hopefully one day will not be tolerated by society. A few months more of life in the end can leave the patient and their family with important time to process and say goodbye, or in some cases enough time to find another option.

#20

There is a limited amount of money to be spent on health care. I want it spent on the young to make their lives better. I don’t think it should be spent on the many older selfish people who only think of themselves.What could give them a couple of months could give younger people years. I am seventy and because of a condition I may have could be dead in a couple of years. I’ve had my days in the sun.

#19

Life should be lived to the fullest, but to extend it beyond it’s natural limits is not moral, nor should our society, and really the rest of the world, prolong it with artificial drugs and therapy.

#18

Yes all treatment required to extend life should be given, if the patients want, and if the quality of that life is acceptable to them. Miracles are possible and new, better treatments are being developed all the time.

#17

I think more investments should go into preventive care and alternative methods of treatment for cancer treatment. All too often many pharmaceutical companies pray on patients who cannot discern the information available about certain treatments and their own personal wishes about their last months or weeks of their life. I think it’s also important that family and/or close friends should be involved in the decision process of the treatment of their loved one (since each person’s needs are different), and if the person’s living will states certain conditions, the doctors and family should honor those wishes (as hard as it may be). That also touches upon the preparation and responsibility each person has in having the correct paperwork involved in their end-of-life. Everyone dies, that is a fact that many Americans have a hard time dealing with, but if each person realizes this and recalls the Terry Schiavo case, I think more would be willing to accept this fact. (I recently watched a great 60 minutes segment about end of life costs)

#16

I think more investments should go into preventive care and alternative methods of treatment for cancer treatment. All too often many pharmaceutical companies pray on patients who cannot discern the information available about certain treatments and their own personal wishes about their last months or weeks of their life. I think it’s also important that family and/or close friends should be involved in the decision process of the treatment of their loved one (since each person’s needs are different), and if the person’s living will states certain conditions, the doctors and family should honor their wishes (as hard as it may be). That also touches upon the preparation and responsibility each person has in having the correct paperwork involved in their end-of-life. Everyone dies, that is a fact that many Americans have a hard time dealing with, but if each person realizes this and recalls the Terry Schiavo case, I think more would be willing to accept this fact. (I recently watched a great 60 minutes segment about end of life costs: http://www.cbsnews.com/stories/2009/11/19/60minutes/main5711689.shtml?tag=currentVideoInfo;segmentUtilities)

#15

Part of the reason the U.S. has such a low ranking in the majority of measurements of wellness among the worlds affluent nations is that we put our resources into crisis medicine instead of preventive medicine. When Doctors go into third world countries they put all their efforts into prevention,but here ‘fee for service’ incetivizes exactly the opposite approach.

#14

Why should this discussion come down to “cost”? There is no cost too high for a human life, and who are we to decide who should receive one more chance to live a little longer?

#13

An assumption that these individuals are past 75 seems to be running through the threads. Who then deserves to receive the care, if we are denying it to others ? Will it be based on age (you must be under 65), or will it be based on who has the celebrity based on the money they have or the name they have made for themselves (as sometimes occurs with organ transplants) ? Avastatin is used to prevent blood vessel growth and thereby inhibiting tumor growth by blocking the blood supply. It is currently being studied as a possible treatment in many different cancers. Who’s to say that someone, depending on the tumor cell type, or other adjuntive therapies being given, would not elicit a cure ? This is the slippery sloap that we will be heading down, if the current health care bills being proposed by the legislature passes. It is another way of rationing care. Maybe people need to do a bit of their own research before commenting. If we block this type of treatment, what’s next ? There’s been plenty of cancer in my family…until you’ve been there, you have no idea what it feels like.

#12

The disdain for the elderly in many of the comments are very disturbing. There are more centenarians then ever and there was a time when people lived much longer then the average 70 years. Who is to say that just because someone crossed a number they don’t deserve medical treatment over a younger person. Very disturbing!

#11

one serious question is the use of pallative care in the treatment of terminally ill cancer patients. My wife died of cancer and was given pallative chemotherapy, supposedly to make her feel better, but it did not. Doctors should be frank with patients and inform them what pallative treatment really is. Will it extend life in a quality manner or just fill the pockets of the providers of this type of care.

#10

It’s irrational to spend limited resources on expensive, marginally effective drugs. An ideal system would be to give dying patients three options, “keep me alive at any cost”, “let me die naturally but keep me pain free”, or “give me a lethal overdose of morphine”.

Personally, the process of dying seems so unpleasant, my preference would be to have the right to authorize euthanasia.

#9

It’s absurd to be spending billions to prolong life for a few months, which in most cases doesn’t improve the quality of life. This is another cost that the American people are not willing to pay for even though I agree with the above writers about the overpayment of certain doctors and drug companies. Most people I’ve talked to think of Dr. Kevorkian as a hero rather than the criminal our misguided laws made him out to be.

#8

I do not want to be kept alive by artificial means. I have talked with my family and provided written instructions to prevent that situation.
I have read that as much as 50% of Medicare funds are spent on end of life proceedures that only extend life for a few months and prolong the suffering of the patient. Physicians must have frank and honest discussions with their patients.

#7

It is long past time that we stop paying whatever outrageous prices the pharmaceutical companies attach to their products. In this particular case where the high cost leads to very little return it is justifiable to deny payment for this treatment from public funds. There is not enough money in the entire world to pay for every high priced drug or procedure for every person.

Governments should start to demand lower prices from pharmaceutical companies and from certain overpriced doctors, such as transplant surgeons and oncologists. Perhaps we need to regulate the percentage of profit allowed for medicines and salaries. I believe that chemotherapy and radiotherapy for cancer is extremely overpriced. Organ transplants cost much more than the cost to provide the service. Even routine surgeries are often outrageously overpriced. We have to put a stop to this. Medicine for profit is not a fair model.

#6

People have to learn to accept that they’re going to die. That money can be better utilized.

#5

I prefer giving the person the option of what medicines to take or not to take.

#4

When we look at this question in isolation it’s easy to answer no. It’s only when we change the question to add “if it means there will not be funds to pay for …” As long as there are limited resources spending money one place means not spending it somewhere else. I challenge you, the media, to change the question and help people understand the real choices that need to be made. And yes, if I was the person with the cancer, I would say no to the drug so the resources could be better utilized.

#3

The U.S. will have to accept the fact that health care dollars need to be spent more wisely. No, vast amounts should not be spent for a few extra weeks of life – money for terminal care that is not palliative should be avoided. These drugs cost thousands per month and could be used for childhood immunization, public health initiatives, etc., with many thousands benefitting. It’s not rationing, it’s rational use of limited dollars.

#2

I believe we should stop financing treatment for any and all diseases in order to extend life by only a few months. This money would better be used to treat the many diseases affecting our young people. The aim of doctors, hospitals and the government should be to make the last few months of life as comfortable as possible and forego any unnessary treatment.

#1

YES! I am 75 and I know I have statistically speaking, about 7 years of life remaining. I have already discontinued the one aspirin a day as an anti-coagulant. I have foregoing plastic surgery when removing some skin cancers. It would be selfish for me to DEMAND every conceivable effort be made to prolong my live. I definitely DO want to die PAIN-FREE. Dr. Kervorkian where are you when I need you? Or must I fly to Washington state to end it all at MY chosen time? Don W

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