Why Our Non-sytstem of Health Care is Bankrupting Us (Provenge, Makena) — While Congress Fiddles, Rome Burns

Two interesting events this week illuminate why health care costs are increasing (by double digit percentages) each year and why they are bankrupting individuals, insurance companies, Medicare, Medicaid, states and indeed the U.S. government.  And while this is happening congress is taking resolute steps to cut NPR’s funding, question individual’s rights to abortion (even in cases of rape, incest and mother’s life risk).  Their budget cuts amount to about 2% of the current budget deficit.  This budget balancing urgency comes after granting a 400 billion dollar a year tax cut.  Remarkable ineptitude.

How health care is  bankrupting us:

1.  Consider the recent rebranding of a long time generic drug hydroxyprogesterone caproate into  Makena.  Without getting into the question of efficacy, consider that hydroxyprogesterone caproate was available for many years at $10-15/ dose from compounding pharmacies.  The branded version of this same exact drug will sell, according to it’s manufacturer, for $1500/dose and the manufacturer expects individuals and insurers to pay.

Now a national pharmaceutical company has gotten FDA approval to make hydroxyprogesterone caproate and will be charging about $1,500 per shot.
KV Pharmaceutical, headquartered in Bridgeton, Mo., received approval Feb. 4 to make and market the drug for the prevention of pre-term labor that for years had been mixed by compounding pharmacies. (at $15, Medicynical clarification)

Medicynical Note:  It’s better than alchemy to be able to make a $15 drug into a $1500 one.  But that’s American ingenuity and creativeness.

2.  Selling a marginally effective drug (Provenge) for $93,000/course of treatment:

Medicare officials said Wednesday that the program will pay the $93,000 cost of prostate cancer drug Provenge, an innovative therapy that typically gives men suffering from an incurable stage of the disease an extra four months to live.

The Centers for Medicare and Medicaid said the biotech drug made by Dendreon Corp. is a “reasonable and necessary” medicine. The decision ensures that millions of men would be able to afford the drug through the government-backed health care coverage. With government reimbursement, analysts estimate Provenge could rack up $1 billion in sales next year. The decision, which will be finalized by June 30, is important for Dendreon because most prostate cancer patients are 65 or older.


“It’s impossible to put a dollar figure on a human life, especially when you’re talking about a drug that has such mild side effects,” said Jim Kiefert, a prostate cancer patient and advocate who was part of the Provenge study. “Of all the treatments I’ve had — with surgery, radiation and hormone treatment — Provenge had fewer side effects than any of them.”

But bioethicists who study health care decisions say Medicare’s ruling on Provenge mirrors the bias of the overall U.S. health system, which emphasizes expensive treatments over basic medical care. Health care costs account for nearly one fifth of the U.S. economy, more than any other country.

Medicynical Note:  It’s obvious to any thoughtful person that unless the cost of care comes down, we can’t afford our non-system.  We pay twice as much as other similar countries and still have 50 million and climbing uninsured.

Resolving the conundrum of health care costs is a major question that instantly strikes our politicians deaf, dumb and blind.  Even the most innocuous suggestion, for example, comparing the efficacy of new drugs against older less expensive ones, in studies not sponsored by drug companies, is considered controversial.

I’m sad for my grandchildren.

Addendum:  4/1/2011 Drug company slashes price of drug from $1500 to $690. A bargain?  Still only 50 times the price of the generic.  Amazing!

The price of an expensive (? Medicynical question mark) drug to prevent premature births has been cut by more than half, following bitter controversy over its high cost.KV Pharmaceutical Co. said Friday that it is dropping the price from $1,500 per dose to $690.

The company got government approval in February to exclusively make the drug named Makena (mah-KEE’-nah), and it hit the market last month. For years, specialty pharmacies had been making a version of the weekly injection for $10 to $20 a dose, so the price of Makena was a shock to doctors who prescribe the drug and private and public insurance programs that pay for it.

It’s hard to tell what’s real on April fools day.

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