What’s A Life Worth?

In recent months, the business press has been abuzz with news about new therapies developed by biotech and pharmaceutical companies for major killers like cancer and rare illnesses such as Pompe disease, an often fatal muscle wasting condition.

However, there is a major issue that prevents some from celebrating these medical breakthroughs.  These drugs are very expensive.  For example, Genzyme, which makes the only available treatment for Pompe, charges an average of $300,000 a year for the medication.  Sensitive to charges that it is profiting on a drug patients are desperate to acquire, Genzyme has a robust assistance program designed to ensure that people have access to the medication.

One of the reasons that drug and biotech firms are able to realize significant profits on these medications is that once a product is approved by the FDA, insurance companies are required (most of the time) to pay for it.  But, there is nothing that says they must cover drugs for uses that are not endorsed by the agency.  This is where medical practice clashes with financial reality. 

Take cancer as an example.  Oncologists are well-known for prescribing drugs off-label, or for uses not approved by the FDA.  Cancer is a difficult opponent and they often must develop cocktails of medications in order to stem its spread.  However, with the cost of cancer drugs reaching epic proportions, insurance firms are fighting back.  They are starting to refuse to cover expensive medications prescribed by oncologists for non-FDA approved uses. 

Consumers are not happy about this new trend.  Patients stricken by disease are desperate for therapies and want the best available – no matter the cost.  Physicians are inclined to agree.  This puts insurance companies in a difficult position.  All life is precious, but can they afford to keep premiums down while paying for expensive medications that may or may not be effective? 

This issue raises three questions:

1.    What’s a life worth?

2.    Can people make hard decisions about the cost of care when they are facing death and disability?

3.    Is there anything we can do to help?

These are tough questions that I don’t have the answers to. However, I’m hoping you can help. 

I’d like to make one final point before I close.  One of the misperceptions people have about universal healthcare is that once it happens everyone will have access to all the medical care they want.  However, even if the nation initiated a single-payer system (which most presidential candidates think is unlikely) we will still have to have this conversation.  Those paying for healthcare, whether they are government, the private sector or individuals will have to decide: what’s a life (mine, my mother’s, my wife’s, my father’s, my child’s) worth?

If we’re going to rely on people to take control of their healthcare, we’re going to have to honestly grapple with the toughest question of all.