What do you think about Medicare covering Dendreon’s treatment for advanced prostate cancer in men over 65 years old? The cost of treatment is $93,000 per patient; the benefit is 4.1 months of life (median). If you think $93,000 is too high a price for 4.1 months, would $50,000 be acceptable? How about $25,000? At what price do you think it’s "reasonable and necessary" for taxpayers to pick up this bill? ~ Ilene
The Poster Child For Medical Hell
Courtesy of Karl Denninger, The Market Ticker
If you’re in the camp that we can fix Medicare and Medicaid, and that the funding problems they face are able to be patched, you need to answer for this:
Dendreon Corp. (DNDN)’s prostate cancer drug Provenge should be covered by the U.S. government for use in older men, regulators said.
The $93,000 treatment regimen is “reasonable and necessary” for men with advanced, castrate-resistant prostate tumors who have minimal or no symptoms of the disease, the Centers for Medicare & Medicaid Services said today.
Note this well – this drug does not cure prostate cancer.
Studies supporting Provenge approval showed the drug helped men with prostate cancer live a median of 4.1 months longer.
3/4 of the men who contract this particular stage and form of prostate cancer that could be treated are at least 65 years old, and thus on Medicare.
So what we’re saying here is that you and I will be forced to pay about $25,000 a month for any man who is at least 65 and contracts this particular form of the disease that is amenable to treatment. That treatment will not change the outcome, and we will pay the nearly $100,000 to give this person four more months of life, on average. (should be "median")
Again, there is no cure. If you have this late stage of the disease, you will die of it.
The question is this: Do you have the right to force society in general to pay for four more months of life for you, if you have not saved the money yourself and are stricken with the disease?
This is part and parcel of what I’ve been talking about in this regard. We can technologically write checks with medical care that we cannot cash as a society. These treatments, along with many others, do not change outcomes. They provide an incremental life extension at extraordinary cost.
We don’t have the money and as we continue to develop more and more treatments like this the problem becomes more and more acute. We cannot afford to buy every 70 year old man a quadruple bypass, nor to pay $100,000 for every prostate cancer sufferer to obtain four more months of life. The money simply does not exist.
This does not mean that you should not have the right to spend your resources however you see fit – including buying that additional four months.
But this conversation, and where the line is, is one we must have as a society. The "open checkbook" fashion in which we "practice medicine" in this regard at the present time is absolutely unsustainable. We are left to choose between that conversation now, and forced collapse of the medical system in the next few years if we do not.
