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August 6th, 2010
03:58 PM ET

Hit by economy, patients can't buy life-saving meds

Cancer patients might not be able to buy life-saving drugs because of the economic downturn, doctors warn.

Two University of California, San Francisco doctors wrote a letter to The New England Journal of Medicine, describing what they had seen in their practice.

Three of their cancer patients had been able to keep their rare stomach cancers at bay by taking a life-saving drug known as imatinib.

Imatinib is effective in stopping the spread of the metastatic gastrointestinal stromal tumor, but it also costs $4,500 a month.

All three patients had started taking the medication in 2001 with great outcomes. But as the economy tanked, one patient had to stop taking the drugs because of decreased family income. Another patient became self-employed and had a preexisting condition, and could not pay for the medication. The third patient's small business failed in 2008 and the person discontinued taking the drug as a result. The tumor recurred in 2009, requiring emergency surgery for that patient, according to the letter.

All three had their conditions worsen, the doctors said.

Without the medication, patients would die of cancer, said Dr. Alan P. Venook, professor of clinical medicine in the division of medical oncology.

Two of the patients are back in remission and one still has a fair bit of cancer, Venook said.  Doctors and the drug maker, Novartis, worked together to get the patients back on their medication.

All three patients were participants in the drug trial that led to the approval of imatinib for treating the tumor.  Venook noted in the letter, "it is an unfortunate irony to find them now unable to afford the drug."

"Though tumor progression might have occurred in all three patients even with medication adherence, their cases illustrate that economic factors can influence the decisions that patients with cancer make about their care," wrote Venook and co-author, Dr. Robin K. Kelley.

Venook said they wrote the letter so other doctors would be aware and get in touch with patients who many not be compliant with their life-saving medication.

“I’m sure it goes on everywhere else,” said Venook.


soundoff (152 Responses)
  1. julie

    for any one needing health care call blue and shield ask about the three products i got great health insurance for 145.00 a month. The pharmacies who have meds to help people then help them and lets start helping people who are laid off they have familie and when you have families you have to put food on the table some times it means going with no meds is that right is that fair. they are hard working great americans we will not bow down to republicans. remember who is fighting in afghanistan our loved ones. we need to help our own people and stop bailing stupid banks and companies who don't care any more. I refuse to surrender to a system who puts a price tag on lives. I feel the pharacuetical companies who make a lot of money should give the meds away and let the government know they care and want health care that will cover all people and forget about price. its the right thing to do.

    August 8, 2010 at 17:53 | Report abuse | Reply
  2. Hillary

    obamacare WILL result in rationing of care and doctor shortages. Bureaucrats will be deciding who gets what. it this rare form of cancer develops in someone over the age of 59 it will be a moot point. They simply will not get the care because life expectancy verses cost will mandate that care and money go to someone more likely to make a return on the federal investment.

    Read about health "care" in Canada, England, France, Spain etc. Their programs are financially unsustainable and rationing DOES happen. Don't just read the "progressive" issued reports on health care in those countries.

    August 8, 2010 at 17:58 | Report abuse | Reply
    • Richey

      I have first hand experience with the German healthcare system which costs less per person than the inefficient American "system" (the American system costs 19x more than the German one) The Germans, by the way, love their healthcare....I don't think you would find many who would trade systems with you.

      August 8, 2010 at 18:25 | Report abuse |
    • TDCHIM

      Health care is already rationed in this country, and doctors' services are already in short supply in some parts of the country. Right now, the insurance companies are meting out care only to those who can afford to keep paying higher and higher premiums and care costs. Doctors clump in urbanized areas because that's where they're trained and where they can make the most money; people in many rural areas have to drive long distances to see physicians. I guess I'd rather have the government in charge of administrating such services than an insurance company interested solely in maximizing its bottom line at my expense.

      August 8, 2010 at 20:08 | Report abuse |
    • ApeHanger

      I have an auto-immune condition that causes the destruction of my platelets, leading to spontaneous bleeding. The most serious complication from this is bleeding in the brain, which if not immediately checked, can be fatal.

      It costs between 2500 dollars and 4000 dollars a week for treatment to keep a lid on the problem. Romiplostim, the drug that is administered, is quite effective and the side-effects are tolerable. However, I recently went on Medicare and, guess what? I no longer am being treated because it costs too much.

      Now, those of you who are enamored with Obama-care should consider that this problem will worsen as costs spiral and the "medical czar" looks for ways to...er...stop the bleeding. I have a few alternatives, though not nearly as satisfactory. What about those who don't have any alternatives?

      August 9, 2010 at 00:04 | Report abuse |
  3. barbara

    The way our health care system is set up is an absolute disgrace. This government allows the existence of and supports for profit health care ins. and places money and lobbying about the needs of it's people. It's immoral and unethical not to have a single payor health care system. So I guess only the very rich deserve to survive cancer. It's outrageous. This is not the greatest country in the world. The greatest country is one that takes care of all it's people in an equitable and fair manner. Don't forget.... no one choses to get sick. No one choses to get cancer. Yet, the way our system is set up... it's punitive.

    August 8, 2010 at 20:16 | Report abuse | Reply
  4. Tom

    that's a lot of money. $54000 a year to live is not cheap.
    There are very real limits to how much we as a society can afford things.
    If they can pay for it themselves, fine.
    But otherwise, hard choicse have to be made, and there's limits to how long life can be prolonged.
    Refusal to make hard choices only yields worse problems elsewhere.

    August 8, 2010 at 20:29 | Report abuse | Reply
  5. Do you people actually think that you know what you are talking about????

    If we had a system where EVERYONE was required to purchased PRIVATE health insurance then yes, the young and healthy would be subsidizing the old. But then again, they already do, ever hear of a little program called MEDICARE???

    This is the system that is in place in that "bankrupt" European country where they have low taxes, high employment and world-class healthcare. The only control that the government has is to set the MINIMUM level of insurance that must be sold to everyone regardless of pre-existing conditions. There are no death panels, no state run hospitals, public options, etc. There is only private healthcare that is paid for through private insurance premiums.

    How is this a bad thing?

    August 8, 2010 at 20:43 | Report abuse | Reply
  6. ApeHanger

    I have an auto-immune condition that causes the destruction of my platelets, leading to spontaneous bleeding. The most serious complication from this is bleeding in the brain, which if not immediately checked, can be fatal.

    It costs between 2500 dollars and 4000 dollars a week for treatment to keep a lid on the problem. Romiplostim, the drug that is administered, is quite effective and the side-effects are tolerable. However, I recently went on Medicare and, guess what? I no longer am being treated because it costs too much.

    Now, those of you who are enamored with Obama-care should consider that this problem will worsen as costs spiral and the "medical czar" looks for ways to...er...stop the bleeding. I have a few alternatives, though not nearly as satisfactory. What about those who don't have any alternatives?

    August 8, 2010 at 21:55 | Report abuse | Reply
  7. just saying

    if americans weren't such fat pigs that can go more than an hour without eating maybe they would be healthier than they're now. I am shocked at the amount of food they eat than complain when they cannot afford anything else. They eat like 20 times or more than foreigners LOL

    August 8, 2010 at 23:39 | Report abuse | Reply
  8. DEEJ

    Strange that many Americans claim that America has the best healthcare in the world. If so, then why is the life expectancy in France and Japan longer than that in America? Why is the baby mortality rate lower in France? Why are there more doctors per capita in France? The only thing America does more than anyone in healtcare – America spends significantly more money.

    August 9, 2010 at 00:34 | Report abuse | Reply
    • ApeHanger

      Life expectancy and health care quality are only indirectly related. Many other factors, including lifestyle, diet, exercies and (OMG!) genetics get into the picture. A lot of Americans eat an unhealthy diet (which is why McDonald's is so profitable) and will pay the consequences as they age. The best health care in the world won't overcome a lifetime of eating greasy crap cooked and served by minimum wage employees.

      August 9, 2010 at 00:57 | Report abuse |
  9. Dalson

    I'm Brazilian and I have been living in the U.S. for a while now. This article touched on one of the subjects that I have been pondering about as I decided to get into medical school. It seems to me that health care in the United States is about the money first, and then about the people. It's a business. You pay or die.

    I don't understand how a rich country like the United States cannot take care of its people's health. Brazil, that isn't as wealthy, provide health care for free to all of its citizens. The rich can still pay for private clinics and buy brand meds, but at least the poor and middle class are healthy. Of course that's paid with taxes, but the only complain that you hear from Brazilians is that they want more hospitals and more medical assistance. People are happier when they are healthy, not when they are fed with dreams of money and stardom.

    Quality of life is too expensive here. People in the slums of Rio de Janeiro eat relatively better, though less, than the average American (rice, beans, chicken, vegetables, and juice are part of a common meal). Those things are cheap. They can also get care, go through surgery, receive organs, and get their meds... all paid with their own taxes.

    August 9, 2010 at 01:21 | Report abuse | Reply
  10. kelly cooper

    when a person dies should we introduce that body into the food chain? you know just those lazy ones who felt that they where entitled to the basic things in life.I think Moses was in a film that kinda ended like that. Just a thought.
    After sending out 200-250 resumes out each month could you please direct me towards the state and or federal job section where I can find all those job offerings? They aren't affected by hiring freezes ?

    August 9, 2010 at 02:12 | Report abuse | Reply
  11. Andy

    So give them out for free.

    - A

    August 9, 2010 at 02:43 | Report abuse | Reply
  12. zann

    @ApeHanger: You are making judgments based on stereotypes that may or may not be true of these people. There are two types of diabetes, one of which is effectively a birth defect – you are born without the ability to produce insulin. The second is when you have a limited ability to process insulin, this type *usually* affects the elderly and worsens with age, but it can be exacerbated by poor nutrition and lack of exercise and be triggered much earlier in life as a result.

    I have a co-worker who developed serious type 2 diabetes suddenly in his mid-thirties – and he has always been thin and athletic. He is in his forties now and is still a tri-athlete – thanks to his medication. Nothing is a simple as stereotypes imply.

    As for high blood pressure – I have had it, and have been taking medication for it, since I was a teenager. It took doctors a long time to figure out why – they think it is because I have very small blood vessels. The small blood vessels probably also explain the history of strokes in my family. I had my first stroke – minor, thank God – in my early forties.

    I grew up on a small rural farm, eating home-grown food – mostly vegetables – and as a result never developed a taste for junk food. My mother, who is 86, was diagnosed with type 2 diabetes when she was 80. The doctor says that most people will develop it at some point in life if they have the genetic tendency for it.

    So to summarize – healthy eating can postpone a person developing type 2 diabetes, but cannot cure it or totally prevent it from occurring. Some people are born with "defects" like small blood vessels or the inability to produce insulin – good nutrition will not prevent high blood pressure or diabetes from occurring in these cases.

    I guess we can't really blame MacDonald's – or the patient – for everything.

    August 9, 2010 at 08:19 | Report abuse | Reply
  13. Dr. Ann

    There is a relationship between Autism and Aspartame. The Senate is determining what correlates with Autism. For the Senate Hearing on Autism going on this month, it may be beneficial to know that along with Mercury and other contaminations in the environment, Aspartame (NutraSweet and Equal) has also been linked to Autism.
    See the chart at http://www.rumormillnews.com/cgi-bin/forum.cgi?read=180197, which shows the timeline of Autism rates with Aspartame product approval and usage rates. Europe has banned the use of Aspartame for pregnant and nursing women as well as children. The countries where Aspartame has been banned or never accepted, their Autism rate is only a small fraction of the U.S. rate. Since Aspartame has been approved in 1981, and placed in soft drinks in 1986, the Autism rate has skyrocketed. The Aspartame notes page explains just a few studies on how Aspartame has been linked with brain disorders.
    Some Main Points:
    Dr. Olney warned of the damage that this product would do to the unborn and to children. He said that the FDA acknowledged “aspartame had been shown to induce brain damage in neonatal animals” but FDA dismissed the neurotoxicity as irrelevant on grounds that the approved uses of aspartame don’t include feeding it to newborn humans. Yet aspartame can be found in prescription and over-the-counter pediatric drugs and in pediatric vitamins. Nursing babies receive this poison from mothers who breastfeed. The recent plague of Attention Deficit Disorder (ADD), Attention Deficit Hyperactivity Disorder (ADHD), autism, and birth defects manifest the neurologic devastations of aspartame. Supporting this view, Dr. Louis Elsas, Emory Professor of Pediatrics and Genetics, testified in a congressional hearing that aspartame is a teratogen (causes birth defects) and a neurotoxin.
    Aspartame is a teratogen that triggers birth defects. It is a deadly neurotoxin (Dr. Louis Elsas testimony before congress, pediatric professor,genetics). Dr. Russell Blaylock, M.D. says aspartame triggers ADD and autism.

    August 9, 2010 at 09:57 | Report abuse | Reply
  14. Squeezebox

    My question about big pharma is when's the last time they invented anything themselves. Their strategy is to watch for biotech companies whose drugs actually get approved. Then they pay big bucks for the companies that invented the drugs to control marketing, distribution, and patents! Big pharma's idea of research is scouring the market for the next up-and-comer!

    August 9, 2010 at 10:20 | Report abuse | Reply
  15. Dave

    Part of the healthcare problem is that WE gave control of medicine to the medical industry. They decide how many people can be admitted to any discipline for training. This control is what drives the cost of many medical specialties. How else do we explain that every x-ray/catscan etc has to be reviewed by a radiologist, who gets $200-300 for a few minutes of work. What a racket!
    The industry sets the standard for treatment, even if their standard is one we cant afford. The fact is that most medicine is routine and does not require a full MD to deal with it. My wife has NO choice – if she wants to get blood pressure medicine, even if she pays for it herself, she MUST have the permission of an MD, every 6 months. Why? Any nurse can validate if blood pressure is good or bad. The consumer is a hostage in our system. Medicare is good ideal – but many medical providers in this country see that as a chance to extort $$$$ from very deep pockets, so they have been sticking it the Govt (ie us) for decades.
    The drug industry works without the burden of free market competition. They charge outrageous prices for drugs because they can. The same reason that Disney charges visitors $40 for a $5 shirt – because they can. They know that medicare has no pay limit – so they stick it to the govt for end of life drugs, chemotherapy drugs, etc. A lot of drug research is actually paid for by us – in the form of research grants to universities, where the researchers and research alike are used by drug companies to make $$$$. They also get to use real sick people to conduct studies – which gives them valuable data for free. Why is there not worldwide free market competition here? Because the American drug industry would lose billions.
    These are not problems fixable by insurance coverage. Insurance only allows the continued extortion of the American people by distributing the cost to more people, so an individual doesn't see the true costs.

    August 9, 2010 at 11:05 | Report abuse | Reply
    • nbbiggs

      You are completely correct. The AMA should have no authority to limit how many people can become doctors. We went to get tetanus shots and we HAD to be seen by a doctor first. That is absurd. Any nurse can give a simple shot. There was no need for the doctor. Drop the AMA rules and prices will plummet.

      August 9, 2010 at 11:57 | Report abuse |
  16. Siegbert Tarrasch

    Sooner or later people are going to get so mad at Corporate America’s pharmaceutical and healthcare insurance “people” that they WILL take what they need…DIRECTLY!

    August 9, 2010 at 11:26 | Report abuse | Reply
  17. jp

    just move to canada...problem solved :)

    August 9, 2010 at 12:25 | Report abuse | Reply
  18. DJ

    Stan,

    Pharmaceutical companies spending on ads outpaces R & D costs and has for a few years now. (http://www.sciencedaily.com/releases/2008/01/080105140107.htm) I have no problem with a company marketing its goods, but don't forget the consumer is paying those costs as well. There is also evidence that direct marketing has lead to a 30% increase in unnecessary prescriptions. (You can do your own research to find those articles.)

    August 9, 2010 at 14:06 | Report abuse | Reply
  19. Scooter Porter

    Why can't people in this country understand that health care is a RIGHT – it is not just a privelege reserved for the rich! WE MUST HAVE UNIVERSAL HEALTH CARE NOW!!!! START focusing on SAVING people and stop thinking that KILLING is the only way to resolve our problems!!!! How stupid can one culture be?????

    August 9, 2010 at 14:12 | Report abuse | Reply
  20. CaretakerOfADiabetic

    As sad as it is for a cancer patient to face this I would like to think even worse is a diabetic. The effects of no medication are more immediate and more devastating. My husband and I went through a period of three years with no health insurance. With his insulin costing upwards of $600 a month we got to a point where we couldn't afford it. We made too much money to go on a patient assistance program and not enough to buy the insulin. I have never been so afraid for his life.
    For those that oppose the new health care plan- grow up and take care of someone who is sick. I would make the stereotype that the people who oppose the plan are self consumed, ignorant adults that have the mentality of a 10 year old child. I wish with all my heart those who oppose the plan would take a day from their own pitiful view of the world and be required to care for a sick person. Feel the pain they feel and the fear that lives with them as they come to understand that because of something as stupid as money they do not have access to the medications that can save their life. Not that I expect anyone with that kind of mentality to grow or change any – but I would like to scare some sense into them. The new health care plan will save hundreds of lives and it will give coverage to people who NEED coverage.

    August 9, 2010 at 16:14 | Report abuse | Reply
  21. Nikki

    THERE IS NO GOOD REASON WHY ANY MED SHOULD COST $4500 A MONTH. R&D costs shouldn't drive pill prices up, especially when taxpayer money subsidizes so much R&D for pharmaceutical companies who then privatize the profit. Giving away a few pills to underinsured patients doesn't justify gouging others.

    President Obama missed the mark. You don't just write a law requiring people to get insurance and call that Healthcare "Reform." Absent restrictions on prescription drug pricing, there is no reform. The new law also fails to reduce the number of years a prescription drug can be trademarked so that more competitive pricing can come much sooner. Look, seeing a doctor isn't what's driving healthcare costs up. This article is trying to show that. But the big question remains: why the $4500 monthly price tag?

    August 9, 2010 at 17:12 | Report abuse | Reply
  22. Elizabeth

    It's not just cancer patients that can't afford their medicine. After the stock market crashed and my college fund went to -$3000, I had to drop out of school, thus being dropped from my fathers insurance. Being able to afford my anti-depressants and anti-anxiety medicine became a huge problem and eventually, we couldn't afford $600 a month for just TWO medicines.

    My old doctor must have had the drug companies sack in his mouth because he refused to prescribe me generics. After 10 months of searching for a doctor, I finally found one an hour and a half away that 1. prescribed me generic forms of my anti-depressants and anti-anxiety medicine 2. didn't charge me a $500 evaluation free 3. didn't make me feel like a charity case, because I'm not. Unfortunately, being without my medicine for 10 months took a pretty hard toll on me both physically and mentally; It was the first time in 8 years I had gone without my medicine.

    I truly feel for all those that are struggling with the cost of prescription medicines . No matter what ailment is being treated, we all deserve to be healthy and happy individuals.

    August 10, 2010 at 16:29 | Report abuse | Reply
  23. Jason

    See, here's the problem. Ethics aside, lets say the goverment decides you always get cheap drugs. The only was it can even remotely afford it if to cut what it pays (like it does with Medicare). However, Medicare payments have gotten so small, doctors are starting not to take medicare patients. Now, the government can make far-reaching legislation, but it CANNOT make products. Therefore, how to you choose to convince a civilian institution performing miracles of chimistry you will likely never hope to understand in your lifetime, to invest their money, labor, research, and jobs for 9 years and HOPE there is a payout if there is not a profit margin to speak of? Who will pay for it? Tax those darned rich guys? Drugs alone wouldn;t even make a dent.

    August 10, 2010 at 20:15 | Report abuse | Reply
  24. opal schaupp

    i am adiabetic and was involved in a car accident lost my job and insurence. my medication is 911.00 a month went to social service and was told it not thier problem. i have had 4 surgeries from this accident and got staff infection. i cant a ford my insulin or my other meds or to have medical treatment once they found out that my medical insurance was maxed out. i told asocial worker that i might as well put a gun to my head and pull the triger at least i wouldnt wont hurt my family as they are watching me die now. i have tried every avenue out thier to get help. but i just get told thiere is nothing they can due. i wear ainsulin pump and insulin is very expensive and all they other mes and ssupplies. i am at the end of the rope and i realiz3e i am not theonly one out there going thhrough hard times . but when you cant sleep for days and have so much pain you just wish it would end. it just seems funny when people are so wond up in the royal wedding and all these people have money and the poor are just left out there to die b3ecause our goverment doest care and the poor just get poorer and lose allsince of hope.

    April 19, 2011 at 22:16 | Report abuse | Reply
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