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View Diary: Monday Night Cancer Club: "The Fix for Cancer Care" (73 comments)

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  •  Sorry I am late (3+ / 0-)
    Recommended by:
    jesmith2, ZenTrainer, peregrine kate

    My son has a rare form of cancer and his treatments have been ridiculously expensive, but not because they are necessarily "cutting edge."

    To shrink the endocrine tumors, they use a synthetic variant of somatostatin known as Octreotide. The problem is that Novartis owns the patent and renewed the patent by creating a long acting version to replace short-acting self-injections. Treatment using somatostatin analog dates back to the early 80s. Each long-acting dose costs $19,000 (although insurance negotiated price is $12,000), which are administered every 3 weeks. Novartis is the problem because in order to insure a profit margin for the LAR Octreotide in a disease with about 10,000 new cases a year, they jack the price and have not been willing to drop down. Patient advocates have been pushing them for years to do so without success. Their patent is coming to an end and new analogs are coming to market, so the market conditions are about to change. However, it is clear that a big part of our health care cost has gone to pharmaceuticals.

    My first reaction to reading the piece is the fear that "bundled" treatment plans sound too much like a one size fits all mode. Also, it could potentially penalize less common forms of cancer where there is high cost relative to outcomes because of less research and more proprietary monopoly.

    The other thought that comes to mind is that the amount of money we spend on biomedical research in this country is absurdly low. Instead of stupid expensive weapons systems, this is where we should be spending. Ultimately, the cost of care would be lower.

    The profit margins in health care delivery and pharmaceuticals are the problem. Laissez faire capitalism has given us the most expensive and least effective medical care system in the developed world. The failure or unwillingness of our elected officials to address this root cause of cost in our system is disgraceful.

    Finally, I am basic agreement with the "high touch" idea except it does not fit with reality. Most physicians I know do not own their own practices, but rather work in large practices, often in large medical center outpatient care offices. The owners of those practices are forcing them into low touch, high volume care. They are seeing 8-10 patients an hour, with 50 hour per week bill cycle.

    Be radical in your compassion.

    by DWG on Tue Mar 26, 2013 at 02:41:11 AM PDT

    •  Wonderful comment! Though I am sorry about (2+ / 0-)
      Recommended by:
      peregrine kate, DWG

      your son. It would be nice if a few folks like you were in on the national discussion group.

      I have been thinking about patents and medicine a lot lately and wondering about the ethical considerations.

      Tracy B Ann - technically that is my signature.

      by ZenTrainer on Tue Mar 26, 2013 at 05:56:59 AM PDT

      [ Parent ]

    •  I recommend everyone (3+ / 0-)
      Recommended by:
      peregrine kate, DWG, ZenTrainer

      read God's Hotel by Victoria Sweet. The author calls it "slow medicine" but her concept is similar to the "high touch" ideas mentioned in comments above.

      Taking profit out of health care crosses all sorts of political divides and is therefore a multi-generational solution. Fortunately, that process began with the introduction of Medicare some decades ago. The ACA assists in moving the idea along, even if it got watered down in committee.

      We need great leaders who are "radical in their compassion." (Thank you DWG.) Obama is one of these.

      We are on the correct path. The evidence for this is demonstrated by the right wing's maniacal opposition to Medicare and the ACA.

       

      •  Another workshop I went to recently was with (2+ / 0-)
        Recommended by:
        jesmith2, peregrine kate

        my oncologist. He heads the research department for lung cancer at a local hospital here.

        All of his slides mentioned something about anxiety and stress, as a factor causing cancer or as a side effect of having cancer etc.

        I asked why, if that is so, anti-anxiety meds aren't given out with each diagnosis.

        Someone else answered that there was just a new decision on a slight change in medical model diagnosis. That was that any patient being diagnosed with cancer needs to be referred to someone to assess their mental and emotional status.

        This at least gets us over to the "right brain' folks who  use the "high touch" methods as a matter of course.

        Tracy B Ann - technically that is my signature.

        by ZenTrainer on Tue Mar 26, 2013 at 08:15:19 AM PDT

        [ Parent ]

        •  Very interesting. Yes, I personally believe (3+ / 0-)
          Recommended by:
          jesmith2, ZenTrainer, DarkHawk98

          stress played a role in my own cancer. (I'm not willing to make a generalization here, or to cite a particular percentage of stress's contribution to my condition.)

          Thing is, what does it mean to have someone "assess" a cancer patient's mental and emotional status? Is there going to be some support provided--free or nearly so--and would that support also be compatible with the patient's own beliefs? It's a good idea but could use some flexibility.

          For the record, I did see a clinical social worker who is part of the oncology team at the hospital for a few months, the first six months or so post dx. She was a nice woman, and generally helpful, but I stopped going to see her for two major reasons. One was that I figured out that the case notes that she was taking about me were part of my medical history with oncology, and I wasn't pleased about that. (They already have enough trouble with being accurate about my medical history.) The other was that after I had the metastases to my lungs, she was ready to start talking with me about end-of-life issues and hospice. No way was I interested in going there. No way. Then and now, I needed to give it my best shot, not fold my tents and give up.

          Some DKos series & groups worth your while: Black Kos, Native American Netroots, KosAbility, Monday Night Cancer Club. If you'd like to join the Motor City Kossacks, send me a Kosmail.

          by peregrine kate on Tue Mar 26, 2013 at 06:34:35 PM PDT

          [ Parent ]

      •  Looks like an excellent book, jesmith2. (0+ / 0-)

        I will have to pick it up soon. Thanks for mentioning it.
        Reminds me it's about time again for another diary on cancer books to recommend.

        Some DKos series & groups worth your while: Black Kos, Native American Netroots, KosAbility, Monday Night Cancer Club. If you'd like to join the Motor City Kossacks, send me a Kosmail.

        by peregrine kate on Tue Mar 26, 2013 at 06:38:19 PM PDT

        [ Parent ]

    •  Thanks, DWG, for stopping by no matter when. (0+ / 0-)

      (Sometimes these discussions do persist for a couple of days.)

      I assume that your son will be on this medication indefinitely? Thank goodness that coverage caps will soon be ended.

      Big Pharma is definitely responsible for a great portion of the health care cost climb in the U.S. There's been relatively little attention paid to that reality, but it persists.

      I agree with your other points as well. We have deeply distorted priorities for research and other social expenditures in this country, and the lack of controls on health care profits is shameful.

      Your observation about most doctors being captured in effect by larger systems is also an important one, something that most outside of the system don't realize at all (and thus can't appreciate the impact of it).

      I hope that your son's health holds steady, at least, and improves in the best case. Good to see you here.

      Some DKos series & groups worth your while: Black Kos, Native American Netroots, KosAbility, Monday Night Cancer Club. If you'd like to join the Motor City Kossacks, send me a Kosmail.

      by peregrine kate on Tue Mar 26, 2013 at 06:43:58 PM PDT

      [ Parent ]

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