Replies to post #157302 on Biotech Values

[iwfal]

Hospital costs for the uninsured or underinsured at institutions such as MD Anderson may indeed be outrageous, but this has little to do with the problem addressed by the editorial: $100,000+ prices for cancer drugs that extend life very modestly.

Yes - and undoubtedly MD Anderson and these MDs make completely reasonable amounts of money in the same situation. Or not (e.g. oncologists are notorious for giving patients drugs that are VERY low probability of success - for instance an aquaintance of mine was just given Zelboraf for melanoma brain mets)?. So two docs from a flagrantly costly institution getting upset about drug prices is about as ironic as it gets.

[iwfal]

this has little to do with the problem addressed by the editorial: $100,000+ prices for cancer drugs that extend life very modestly.

BTW - that editorial had yet other problems. For instance the claim that 'only three were found to improve survival' may be true - but it is undoubtedly very misleading. For instance the CLL drug Bosutinib was probably not included in that list of 3 - because it was approved based upon Major Cytogenic Response. But it almost certainly does improve survival - it just isn't yet 'proven'. Similarly another of the 2012 Onc approvals was for Jakafi for Myelofibrosis. Maybe it improves survival, maybe not - but that wasn't the basis of approval (obviously - since myelofibrosis isn't immanently fatal). Instead the basis was, essentially, QoL. A worthy goal. So the editorial writers were, to a significant degree, using misleading statistics.

BTW 2 - I'd love to see QALY as a universal judgement tool for re-imbursement. But I'd equally like to see MD specialist salaries significantly reined in - so I find such editorials very self-serving and un-self-aware.

[hirogen]

Hospital costs for the uninsured or underinsured at institutions such as MD Anderson may indeed be outrageous, but this has little to do with the problem addressed by the editorial: $100,000+ prices for cancer drugs that extend life very modestly.

I agree with the points in the editorial, but I also agree with Clark that the MD Anderson's need to look in the mirror. Cancer drug costs are escalating but then so is cost of overall cancer care of which drugs currently comprise a fairly low (~20% in 2010) percentage.

http://healthland.time.com/2013/02/20/bitter-pill-why-medical-bills-are-killing-us/

[iwfal]

Hospital costs for the uninsured or underinsured at institutions such as MD Anderson may indeed be outrageous, but this has little to do with the problem addressed by the editorial: $100,000+ prices for cancer drugs that extend life very modestly.

Medical cost inflation - found the following article on medical costs (I believe part of a series at the NYT), and apropos of the above, it notes that medical costs are driven first by hospital costs, second by md's. It also gives some stats on md earnings inflation (much faster than inflation for decades for many (probably all) specialists - and even for laggard traditional GPs).

http://www.nytimes.com/2014/01/19/health/patients-costs-skyrocket-specialists-incomes-soar.html?_r=1