We have been so insensitive to the costs of health care that only now after costs have skyrocketed to the $100,000/year and more for a single drug do we think we need to mention it to patients. Doctors are now being prompted and coached on how to talk to patients about costs.

“Chemotherapy costs are rising so dramatically that later this year, oncologists will get their first guidelines on how to have a straight talk with patients about the affordability of treatment choices, a topic too often sidestepped.”

Other interesting comments from the article:

“Drug prices are a growing issue for every disease, especially for people who are uninsured. But cancer sticker shock is hitting hard, as a list of more advanced biotech drugs have made treatment rounds costing $100,000, or more, no longer a rarity. Also, patients are living longer, good news but meaning they need treatment for longer periods. The cost of cancer care is rising 15 percent a year”–Medicynical note: that’s $100,000/year

“Gleevec, for example, has revolutionized care for a type of leukemia — and the prices reflect manufacturers’ years of research and development investment.” Medicynical note: Gleevec (imitinab) is an interesting example. It was largely developed with tax payer financed research. Development costs were minimal because it was such a major improvement over previous medications for chronic myelogenous leukemia–only a handful of small studies were necessary to prove safety and efficacy. Yet the drug costs in the range of $50,000-$100,000/year depending on the diagnosis and stage of the disease.

Health care costs are the leading cause of personal bankruptcy in the U.S. (data prior to current mortgage crisis).

Do you think that cost is affecting care? What are the ethics of this situation? Does the system have an obligation to assure patients access to the best treatment? What is best? Would you believe that cost efficacy (assessments of efficacy and value) is not considered by Medicare in it’s coverage? Is this a problem?

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