How Much Is 1.6 Months of Life Worth?


From Carolyn Johnson at Wonkblog:

With some cancer drug prices soaring past $10,000 a month….

Hey, that’s me! A friendly FedEx delivery person just delivered this month’s $10,000 supply to me an hour ago. So, what’s up?

With some cancer drug prices soaring past $10,000 a month, doctors have begun to ask one nagging question: Do drug prices correctly reflect the value they bring to patients by extending or improving their lives?

A study published Thursday in JAMA Oncology aims to answer that question by examining necitumumab, an experimental lung cancer drug….in a clinical trial, researchers found that adding the drug to chemotherapy extended life by 1.6 months, on average.

….In order to estimate what the price of this drug “should” be based on its value to patients, the research team modeled various scenarios….one additional year in perfect health in the U.S. is worth somewhere between $50,000 and $200,000….Based on their calculations, the drug should cost from $563 to $1,309 for a three-week cycle.

….There are many variables that go into the price of a drug, but mounting evidence suggests that the value it brings to patients is not the biggest factor. “How they price the drug is they price it at whatever the market is willing to bear,” said Benjamn Djulbegovic, an oncologist at the University of South Florida.

Well, sure, but this raises the question of why the market is willing to bear such high prices. Why would an insurance company approve a large expenditure for a drug that has only a tiny benefit?

There’s a lot that goes into this. Obviously some people benefit from necitumumab by a lot more than 1.6 months—and there’s no way to tell beforehand who will and who won’t. And it costs a lot to develop these drugs. And patients put a lot of pressure on insurers to cover anything that might help. And, in the end, insurance companies don’t have a ton of incentive to push back: if drug prices go up, they increase their premiums. It doesn’t really affect their bottom line much.

There’s also the size of the total market to consider. The chemo drug I’m currently taking, for example, is only used for two conditions. There’s just not a whole lot of us using it. In cases like that, a drug is going to be pretty expensive.

But here’s something I’m curious about: who puts more pressure on insurance companies to cover expensive drugs, patients or doctors? My doctor, for example, was totally gung-ho about my current med. I was much less so after I read some of the clinical studies online. Why? Because most chemo drugs have unpleasant side effects (though mine has turned out OK so far), which means that, like many patients, I’m reluctant to take them unless the benefit is pretty clear cut. Doctors, on the other hand, just want to do whatever they can to help, and have no particular incentive to hold back. So maybe it’s doctors who need to be in the forefront of pushing back on expensive drugs. They’re the ones in the doctor-patient relationship who know the most, after all.

DOES IT FEEL LIKE POLITICS IS AT A BREAKING POINT?

Headshot of Editor in Chief of Mother Jones, Clara Jeffery

It sure feels that way to me, and here at Mother Jones, we’ve been thinking a lot about what journalism needs to do differently, and how we can have the biggest impact.

We kept coming back to one word: corruption. Democracy and the rule of law being undermined by those with wealth and power for their own gain. So we're launching an ambitious Mother Jones Corruption Project to do deep, time-intensive reporting on systemic corruption, and asking the MoJo community to help crowdfund it.

We aim to hire, build a team, and give them the time and space needed to understand how we got here and how we might get out. We want to dig into the forces and decisions that have allowed massive conflicts of interest, influence peddling, and win-at-all-costs politics to flourish.

It's unlike anything we've done, and we have seed funding to get started, but we're looking to raise $500,000 from readers by July when we'll be making key budgeting decisions—and the more resources we have by then, the deeper we can dig. If our plan sounds good to you, please help kickstart it with a tax-deductible donation today.

Thanks for reading—whether or not you can pitch in today, or ever, I'm glad you're with us.

Signed by Clara Jeffery

Clara Jeffery, Editor-in-Chief

We Recommend

Latest

Sign up for our newsletters

Subscribe and we'll send Mother Jones straight to your inbox.

Get our award-winning magazine

Save big on a full year of investigations, ideas, and insights.

Subscribe

Support our journalism

Help Mother Jones' reporters dig deep with a tax-deductible donation.

Donate

Share your feedback: We’re planning to launch a new version of the comments section. Help us test it.