Since becoming a doctor, I've been increasingly troubled by how hard it is to get treatment to those who need it most. Sure, there are a lot of uninsured people -- everyone knows that -- but that isn't nearly the whole story. Simply put, even for those who have insurance, medical care is expensive. The co-pays can be very costly, and if you have any sort of chronic illness, you may pay more for medicine than for rent.
Even though I'm well-acquainted with the expensive nature of healthcare, I was stunned when I read a report recently by a pharmacy benefit manager, Express Scripts. It showed that cancer drugs prescription costs went up 16 percent last year. All other prescriptions went up by an average of three percent. We are talking about cancer, where unfortunately the only parameter of success is life or death, and it is getting increasingly expensive to live. As things stand now, it costs around $1600 per month for many cancer medications.
Of course, those are all just numbers and may not mean a whole lot to some people. However, a little girl that I met a couple of years ago may shed some light on the issue.
Ally Krowski is 6 years old. This impossibly cute girl developed some really bad back pain one day. Within a few weeks, she couldn't even walk. The diagnosis: Ewing's Sarcoma. There was a tumor pushing on her spine and her doctors were not optimistic that she would walk again or even survive. For Ally, the story ended up being a good one. She was flown to MD Anderson Cancer Center and received an experimental drug that saved her life. I still remember her mother crying tears of joy when she realized Ally would live.
Unfortunately, that life saving medication was expensive, too expensive to make anymore. So, for the next Ally, a medication that could possibly save her life may not be around. We are told there is only enough left to treat a few dozen children.
It is easy to get outraged by this fact, but it's also important to understand how drug companies make these decisions. In Ally's case, her cancer, Ewing's Sarcoma, is considered an "orphan disease," one with fewer than 200,000 new cases every year. At some point, it becomes increasingly difficult for drug companies to make medications that few people will use.
To be sure, according to a recent report, the drug industry does give more than $8 billion worth of cash and products to people who can't afford medications. And drug companies do need to turn a profit in order to develop the next generation of drugs.
So how do we reconcile this problem as a society? If you make the greatest cancer drug in the world, but it is too expensive, what good is it? I am anxious to hear your thoughts.