Yervoy for Melanoma $120,000 for four injections,

The good news is that there  may be a drug that improves, somewhat, the survival of patients with malignant melanoma.

The bad news is that the drug company marketing the drug, Bristol Meyers,  is charging $120,000 for a course of treatment, four injections over three months.

In that randomized clinical trial, patients with metastatic melanoma treated with Yervoy lived a median of about 10 months, compared with 6.4 months for patients in a control group, who received a treatment believed to have had little effect.

And:

More than 20 percent of the people who received Yervoy in the trial lived at least two years, and some of them much longer. But there is no way at present to predict which patients will benefit from the drug.

But, always a but:

The drawback is that loosening the restraints on the immune system can lead to dangerous side effects, the most worrisome being colitis and diarrhea, but also hepatitis, endocrine dysfunction and skin problems. The F.D.A. said that 12.9 percent of patients treated with Yervoy suffered severe or fatal autoimmune reactions.

Medicynical Note:  The drug in this early study appears to have some efficacy and significant toxicity. Half the patients treated get less than a 4 month survival benefit–if this study’s finding hold up in the future.  (It should be noted that  first studies often show better results than confirmatory studies)

Can our non-system of care afford a $120,000 drug that improves survival just 4 months?  Can 99% of our citizens afford such a drug if insurance doesn’t cover.

The pharmaceutical industry deserves credit for helping develop an  drug with some efficacy.  But charging 3-4 times the average person’s income/year, takes the pay us or die ethic to a new extreme.

The question is not whether we will ration care by cost to most people but how.  It should be understood that whatever the approach we take,  republican or democratic, the wealthy will be more able to afford that which is not covered by insurance. 

We may have the opportunity in future elections to decide. 

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2 responses to “Yervoy for Melanoma $120,000 for four injections,

  1. I read a testimony that someone was successfully treated with Yervoy. But since there is no guarantee that this happy ending will repeat itself in the vast majority, is the risk and cost worth it? Why would a drug company seize upon the opportunity to hold sick people hostage until they rob them to death? Doctors say that dietary intervention is “hogwash”. Arrogance doesn’t want to learn new tricks. Alternative medicine and nutrition does work, and is still working at a far less cost than Yervoy, without the side effects. If the cancer is already widespread in the organism, obviously the organism cannot survive. But why tell people that nutrition doesn’t work? Give the body what it needs at the beginning of the diagnosis, and see what happens!! Doesn’t mean that conventional medicine cannot be used. The death rate from conventional approaches far exceeds the death rate from nonconventional approaches.

    • Sadly diet therapies while sometimes maintaining nutrition and avoiding the toxicity of medications has never, never, never been shown to alter the course of progressive malignant disease. There are no such studies. Delaying medical treatment to try such interventions, however, can be fatal. Consider the case of Steve Jobs. In the end he is reported to have regretted trying diet and alternative approaches. When he finally sought medical care his tumor was unresectable and died of his disease. Consider people with advanced curable cancers and leukemia (testicular cancer, some of the acute leukemias and lymphomas) delay in using medications can make the difference between cure and a fatal illness. Or consider people delaying dealing with early breast cancer or other localized malignancies to try nutritional interventions.

      I’ll grant you that there are a number of instances where aggressive treatment is futile and the benefits very limited, in which case the best approach is supportive care, doing whatever is necessary to maintain comfort and nutrition…as possible.

      In my 40 or so years of managing patients, I have never ever seen patient with malignant disease respond to nutritional interventions. I have seen reports of poorly documented cases claiming efficacy but when looked at closely, when information was made available, they were people without documented disease, patients post resection of tumors or people without malignant disease who assumed that nutrition did something to prevent recurrence–an unprovable contention.

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