A decade ago, when I first returned to the business beat, a company called Dendreon began pushing a non-cure for prostate cancer called Provenge.
The idea was to fit a therapy specifically to a patient’s DNA. This cost a lot of money. While Provenge did extend life, it was only by a few months. For this Dendreon wanted $93,000.
If I had all the money in the world, I’d pay that. But if every prostate cancer patient could force insurers and government agencies to pay that, the system would go broke. You can’t have an unlimited draw from a limited pool of funds. (To the right, at the upper right, is my late mother. I learned recently she taught the first "integrated" second grade class in California history, in 1947. I am very proud of her.)
Fast forward to today. Eli Lilly and Biogen have developed drugs to treat Alzheimer’s Disease.
I said treat, not cure.
Both drugs attack the amyloid plaques that have become a symbol of the disease. Both companies have slowed symptoms in studies.
Neither drug is a cure, or anything like it. It’s possible, even likely, that there’s something behind the amyloid plaques, something else causing the disease. It could be stress on the nervous system. It could be inflammation. It could be a combination of things. It could be an inherited condition involving lysosomes, the “rubbish bins” within cells that break down sugars and lipids into nourishment.
Biogen wants $119,000 for its drug. Lilly wants “just” $44,600. The National Institutes for Health estimates the former adds just .113 years of “quality” life, the latter .408 of a year. If they gave patients an extra year of quality life (as opposed to the two years my late mother was in nursing care) it’s nearly $1 million. Per patient. And they don’t add a year of quality life. They add 1-5 months.
We can’t afford it.
The problem is that under current law, Biogen and Lilly can make insurers pay it. (That's the Biogen drug to the right.) Once a drug is approved by the FDA, it can be prescribed and, once prescribed, it must be paid for.
This is untenable. I must repeat. You can’t have an unlimited draw from a limited pool. Public or private, Medicare or insurance, there’s a limit to how much money is available, and someone must, at some point, have the power to say “no.”
Provenge failed. Dendreon was sold. But Lilly and Biogen are going to fight, and they’re going to survive. They have a powerful lobby, the Alzheimer’s Impact Movement, trying to make the government (and you) pay their price.
I get it. I’m 68. I’m genetically susceptible to dementia, more so every year. And the thing you most want at 68 is 69. When my mom was in that nursing home at 93, she wanted 94, despite her condition. She didn’t get it.
Father Time is undefeated. You can’t have an unlimited draw from a limited pool.
We must make choices.
My choice is to let private parties buy these drugs if they want, but to wait for a cure, and to only pay what that cure cost to research and make, plus a reasonable profit. I’m tired of this drug industry nonsense that drugs must be priced based on how much “quality life” they deliver. The whole attitude is barbaric.
There are also other killers out there.
