Today’s Managing Health Care Costs Number is $ 162,351
Tom Brokaw had a moving piece in Sunday’s NYT Week in Review about his three years of living with a diagnosis of multiple myeloma. He’s had back surgery “which reduced my height by 3 inches,” lives with back pain and fatigue, and has developed a new set of colleagues – and a new appreciation for time with his grandchildren.
But this is a blog about health care costs – and this line caught my attention:
Even in remission, cancer alters a patient’s perception of what’s normal. Morning, noon and night, asleep and awake, malignant cells are determined to alter or end your life. Combating cancer is a full-time job that, in my case, requires 24 pills a day, including one that runs $500 a dose.
Here are drugs commonly used to treat multiple myeloma – a disease that had no especially effective treatment until about ten years ago:
| Brand Name | Generic | Annual Cost |
| Velcade | Bortezomib | $ 92,352 |
| Thalidomid | Thalidomide | $ 127,346 |
| Revlimid | Lenalidomide | $ 162,351 |
| Ninlaro | Ixazomib | $ 124,848 |
| Darzalex | daratumunab | $ 54,000 |
| Empliciti | Elotuzamab | $ 105,600 |
Sources for drug prices Lexicomp via UptoDate, and Medical Letter for Empliciti
This is bad news for patients- Wonkblogrecently reported on the fact that those on Medicare were much more likely to delay Gleevec therapy for chronic myelocytic leukemia if they did not have a subsidy for their medications – no surprise when the median out of pocket spending on this medication was over $8500 per year.
It’s clearly important to shield patients from ruinous out of pocket costs which might make many forgo “high value” therapy. But a cap on patient out of pocket liability isn’t enough to address the issue. We need an approach to lower effective drug prices – and simply shifting these from patient to payer will simply raise premiums, and could even decrease pressure on pharmaceutical companies to stop raising prices.
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