Today’s New York Times carried a front page article about the high cost of the new prostate cancer treatments. This article seems to be the talk of the town and the talk (based on the comments that have been entered on-line) has been anything but positive. Unfortunately, many of the comments have made with the incorrect assumption that the side effects of these new treatments are horrific. As we know, for most men this is not the case. Actually, the treatment Provenge as mentioned in the article, provides the longest extension of live with the least side effects of almost any other cancer treatment for any cancer!
I do have to admit that other comments have raised excellent issues, especially about the real and equitable distribution of medical assistance. They also have raised the issue about Medicare (which pays for the vast majority of these treatments for advanced prostate cancer) being unable to negotiate the price of the treatments. Clearly, this issue has reached the time and needs to be re-evaluated.
The other missing insight to the comments is a lack of general understanding of the statistical analysis of the survival advantages experienced by men with advanced prostate cancer. Means, averages and medians are all different measures of survival and most people, including those making comments neither understand this nor just elect to ignore this issue. It is not OK to quote statistical survival advantages without understanding what they mean. One commenter even said that they cannot possibly know that any men lived longer.
There is no question that cancer drugs are expensive but we are still in the infancy of treatment development. As time goes on not only do we develop more treatments that extend life, but we also increase the median survival time provided by the progression of these drugs. There is no reason to believe that this trend will not continue.
President Obama received a lot of flack about “Obama Care.” He was falsely accused of creating “Death Panels.” If you read the New York Times comments posted today, almost every one of them actually advocate an equivalent of these “Death Panels.” So, one could say that the American Public is in favor of “Death Panels.”
There is no question; we need to take a long and hard look at the cost of healthcare in the United States. We also need to look at how healthcare is actually delivered in the United States. We can deliver better healthcare in a much more humane manner, but we need to consider a ground up re-creation of how healthcare is delivered in the United States. Our current system is both expensive and broken. We need to have the Federal Government re-imagine the healthcare delivery system, but this re-imaged system must include experts in healthcare delivery, doctors, researcher and consumers, all with an equal voice.
Joel T Nowak. M.A., M.S.W.
Joel: I agree with all of your points until the last paragraph. While the Federal Government might be one of the parties in a process to re-imagine the healthcare system, I think the Feds squandered their credibility in the Health Care Reform Act of 2010 to ever take o the role as the lead architect of a new health care delivery system. While there are admirable aspects of the law, in the main it flies in the face of economic reality–not to mention its likely dismemberment on constitutional grounds.
I think the States could fit your vision to be excellent laboratories to develop a variety of creative new approaches. Then, comparative judgements could be made, and the best aspects of different approaches could be implemented on a larger scale. But Washington as lead dog? No thank you.
Excellent summary of the article and you raise many good points.
I think one of the other interesting points raised by Dr. Charles Meyers in the article was that when calculating the impact on health care costs one has to realize that these treatments are not being given to ALL prostate cancer patients but instead to a small subgroup. This cost then needs to be viewed against the millions of patients in the health care system who are not PCa patients and the many thousands of PCa patients who will never need these treatments.
Individually a very expensive treatment and it raises the valid question, especially for patients with little or no health insurance, how are these prices set and are they fair and reasonable? But the aggregate impact on national health care costs may be small indeed.