Just to be clear my living will calls for enough opiates to make final final days or months comfortable with limited medical interventions. My late father had multiple medical interventions in the final decade of his life which for the most part only resulted in a hell on earth. My late uncle had lung cancer which had spread to his spine. He had 100s of thousands of dollars in chemo therapy which also resulted in a hell on earth in his final years. He eventually died from multiple organ failures as a result of the chemo therapy. The one thing that is missing from US healthcare is an analysis of return on investment.
A study published Thursday in JAMA Oncology aims to answer that question by examining necitumumab, an experimental lung cancer drug made by Eli Lilly & Co. The drug isn’t approved yet, and Eli Lilly has not set a price. But there is data on how well it works: in a clinical trial, researchers found that adding the drug to chemotherapy extended life by 1.6 months, on average, for patients with a dire prognosis — a type of non-small cell lung cancer that has spread.
In order to estimate what the price of this drug “should” be based on its value to patients, the research team modeled various scenarios. Generally, economists suggest that one additional year in perfect health in the U.S. is worth somewhere between $50,000 and $200,000 a year. Although patients taking necitumumab lived longer, people with advanced cancer often have a lower quality of life than healthy people and the researchers took that into consideration.
With a limited healthcare budget should we really be spending hundreds of thousands of dollars to keep someone in their late 80 s alive for a few more months especially if their quality of life is reduced?
“Currently, the prices of cancer drugs are increasing, and the prices are not linked to the benefit that the drug provides,” Daniel Goldstein, an oncologist at the Winship Cancer Institute at Emory University who led the study, said in an e-mail.
“We propose that drugs that provide a minimal benefit should have a low price, while drugs that provide a major benefit should have a high price. This method of value based pricing will financially incentivize researchers and industry to develop truly game-changing innovations.”
I think the same applies to cardiovascular medical interventions for those in their late 80 s and 90 s. My late father may have lived longer but did he really live. I’m not so sure.