Costly drugs force life-death decisions

[Christine MH-UK]

The problem in the UK at least is that the government can be rather slow at recommending that a drug be provided. For example, the HERA trial results came out in May 2005 and it was pretty clear that the benefits had to outweigh the risks for at the very least high-risk patients, but the NHS in my area didn't start paying for herceptin for early breast cancer for anyone until January and it was relatively early compared to other areas. Because of the delay, there were alot of patients scrambling to find the money for potentially life-saving treatment. I myself had to pay for four months of herceptin out of pocket. I do worry that the two-year arm of HERA will report out with stunning results and I will have to go back to the private sector for an expensive second year and I worry about what I might end up spending for cutting edge medicines if the cancer came back.

The bit about the US government not being able to negotiate prices is relatively new, only about three years old.

The argument made against negotiating prices is that in some countries governments have used their bargaining power to pay pretty close to the unit cost of manufacturing the medicine, so some fairly wealthy countries, including France and Germany, it has been argued, are not contributing to R&D costs. The UK strategy is to allow an 8% profit on patent medicines, largely because it has a domestic pharmaceutical industry to support, but bargain very hard on non-patent medicine. Still, seems unfair that the US government lacks the negotiating power of even the big health insurance providers when it comes to drugs prices, especially since it provides so much money to fund the basic science on which the industry relies.

At the same time, I think that it is important to keep in mind that before cancer drugs became such money spinners, pharmaceutical companies weren't so interested in them. A friend of mine who works in the industry pointed out that the drugs companies don't need to work on cancer to make money: they can concentrate on more common afflictions such as baldness and obesity and do just fine.