Replies to post #92434 on Biotech Values

[DewDiligence]

BSX update:

The Company plans to fully evaluate the impact of these actions on its financial results and provide an update when the evaluation is completed. Given the financial uncertainty involved, these actions could have a material impact on the Company's previously issued guidance, including revenue, operating profit and cash flows for the first quarter and full year of 2010.

http://finance.yahoo.com/news/Boston-Scientific-Announces-prnews-822503259.html?x=0&.v=1

Oops.

[medchal]

Re:  ICDs, medical costs, etc:

In a couple of weeks, I'll have my annual visit with my cardiologist (cut from quarterly visits by Medicare policy).  I'll spend ten minutes with him, five of which will consist of another hotboxing session to convince me that I should have a pacemaker-defibrillator implanted to the tune of $40,000 to $60,000.  (The last time I bothered to look up the statistics, well over 100,000 of these gems were being implanted per year, with the number still rising exponentially--a true growth industry--meaning that probably $5BB+ per year was being spent on these procedures.*)  The cardiologist will be unhappy with my latest echocardiogram because it will show no improvement in heart function.  (It's would be very difficult to gain "improvement" after two heart attacks which have severely damaged the heart muscle.)  I do not now have, nor have I ever had, any significant arrhythmia, but I will be told again about the marginal improvement that could possibly (probably?) be gained by the use of such a device which, from everything I read, is the very latest latest in medical fashions.  Meanwhile, instances of misfiring defibrillators continue to occur sporadically.  I have personally known of one man whose life has been saved by a defibrillator (twice) because he has severe arrhythmia; I have also known one man whose defibrillator fired dysfunctionally and gave him quite a jolt (nothing deadly, of course).  One of my biggest fears concerning these devices is that I may find that Microsoft provided some of the programming used in them.

After my visit to my cardiologist, I'll have my annual physical, at which a $5,000 colonoscopy will be strongly recommended (even though I'm past the age at which it would have the highest putative benefit, and even though the latest literature I have read indicates a cost of a couple of millions of dollars to locate one case of incipient colon cancer, many of which would also be found by a $50 analysis of stool samples).

Meanwhile...meanwhile...I read here almost constantly all the blather about how medical costs are rising because of the greed of insurance companies, and how the government could handily fix the problem of escalating medical costs.  I've got news:  The only fix for constantly rising medical costs is to curb the constant demand for marginal and expensive medical procedures.  Medicare and my supplemental insurance (which is to say, you fine people) would cheerfully pay for the procedures spoken of above.  The fact is, government control almost certainly would actually (and only eventually) rein in medical costs by reining in our seeming endless appetites for the best, latest, and most expensive medical treatments, but somehow, I don't think that's what the proponents of socialized or government-controlled medicine are trying to sell. The only other possible way to lower medical costs, or the trajectory thereof, is to lower the compensation of those providing the services, which would no doubt also happen.

Chipping away at costs by limiting my cardiologist's appointments to one per year, or refusing to pay for my annual physical (Medicare does not reimburse this), is not going to do the trick.  Laying the wood on insurance companies, let alone tongue-lashing them about their supposed (mostly imaginary) moral failings, won't do it either.  Those of you so very agitated and distressed about these issues might do better to consider what medical services you are willing to go without--and you will go without some of them, sooner or later, under any system of government controls (also known as veterinary medicine)--than how many licks you can put on insurance companies and those politicians you don't like.

I'll forego the $75,000 or so I could incur on medical procedures (including follow-up) this year alone.  What are you willing to "sacrifice"?  Giving up delusions of why medical costs are rising might be a good start.
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*"Information regarding cost implications of ICDs continues to emerge. The MADIT II study showed that prophylactic implant of a defibrillator reduced the rate of mortality in patients with a previous myocardial infarction and low LVEF. The cost analysis phase of the study showed that, during the 3.5-year period of the study, the average survival gain for the defibrillator arm was 0.167 years (2 mo), the additional costs were $39,200, and the incremental cost-effectiveness ratio (iCER) was $235,000 per year-of-life saved. In 3 alternative projections to 12 years, this ratio ranged from $78,600 to $114,000. Estimated cost per life-year saved is relatively high at 3.5 years, but projected costs are substantially lower over the course of longer time horizons."

http://emedicine.medscape.com/article/162245-overview