Money Matters
Posted by Michelle Moquin on October 6th, 2014
Good morning!
Naomi, Patricia, Janet: I saw 60 minutes too last night. I was so disgusted by these companies making so much money by taking advantage of people and their emotions…people that are dying from cancer and desperate to live.
Great suggestion to post this write Janet. Thank you. Here is the segment and the script from 60-minutes:
The cost of cancer drugs
Lesley Stahl discovers the shock and anxiety of a cancer diagnosis can be followed by a second jolt: the astronomical price of cancer drugs
The following is a script of “The Cost of Cancer Drugs” which aired on Oct. 5, 2014. Lesley Stahl is the correspondent. Richard Bonin, producer.
Cancer is so pervasive that it touches virtually every family in this country. More than one out of three Americans will be diagnosed with some form of it in their lifetime. And as anyone who’s been through it knows, the shock and anxiety of the diagnosis is followed by a second jolt: the high price of cancer drugs.
They are so astronomical that a growing number of patients can’t afford their co-pay, the percentage of their drug bill they have to pay out-of-pocket. This has led to a revolt against the drug companies led by some of the most prominent cancer doctors in the country.
Dr. Leonard Saltz: We’re in a situation where a cancer diagnosis is one of the leading causes of personal bankruptcy.
Dr. Leonard Saltz is chief of gastrointestinal oncology at Memorial Sloan Kettering, one of the nation’s premier cancer centers, and he’s a leading expert on colon cancer.
Lesley Stahl: So, are you saying, in effect, that we have to start treating the cost of these drugs almost like a side effect from cancer?
Dr. Leonard Saltz: I think that’s a fair way of looking at it. We’re starting to see the term “financial toxicity” being used in the literature. Individual patients are going into bankruptcy trying to deal with these prices.
“I do worry that people’s fear and anxiety’s are being taken advantage of.”
Lesley Stahl: The general price for a new drug is what?
Dr. Leonard Saltz: They’re priced at well over $100,000 a year.
Lesley Stahl: Wow.
Dr. Leonard Saltz: And remember that many of these drugs, most of them, don’t replace everything else. They get added to it. And if you figure one drug costs $120,000 and the next drug’s not going to cost less, you’re at a quarter-million dollars in drug costs just to get started.
Lesley Stahl: I mean, you’re dealing with people who are desperate.
Dr. Leonard Saltz: I do worry that people’s fear and anxiety’s are being taken advantage of. And yes, it costs money to develop these drugs, but I do think the price is too high.
The drug companies say it costs over a billion dollars to bring a new drug to market, so the prices reflect the cost of innovation.
The companies do provide financial assistance to some patients, but most people aren’t eligible. So many in the middle class struggle to meet the cost of their co-payments. Sometimes they take half-doses of the drug to save money. Or delay getting their prescriptions refilled.
Dr. Saltz’s battle against the cost of cancer drugs started in 2012 when the FDA approved Zaltrap for treating advanced colon cancer. Saltz compared the clinical trial results of Zaltrap to those of another drug already on the market, Avastin. He says both target the same patient population, work essentially in the same way. And, when given as part of chemotherapy, deliver the identical result: extending median survival by 1.4 months, or 42 days.
Dr. Leonard Saltz: They looked to be about the same. To me, it looked like a Coke and Pepsi sort of thing.
Then Saltz, as head of the hospital’s pharmacy committee, discovered how much it would cost: roughly $11,000 per month, more than twice that of Avastin.
THE “EYE POPPING” COST OF CANCER DRUGS
Lesley Stahl: So $5,000 versus $11,000. That’s quite a jump. Did it have fewer side effects? Was it less toxic? Did it have…
Dr. Leonard Saltz: No…
Lesley Stahl: …something that would have explained this double price?
Dr. Leonard Saltz: If anything, it looked like there might be a little more toxicity in the Zaltrap study.
He contacted Dr. Peter Bach, Sloan Kettering’s in-house expert on cancer drug prices.
Lesley Stahl: So Zaltrap. One day your phone rings and it’s Dr. Saltz. Do you remember what he said?
Dr. Peter Bach: He said, “Peter, I think we’re not going to include a new cancer drug because it costs too much.”
Lesley Stahl: Had you ever heard a line like that before?
Dr. Peter Bach: No. My response was, “I’ll be right down.”
Lesley Stahl: You ran down.
Dr. Peter Bach: I think I took the elevator. But yes, exactly.
Bach determined that since patients would have to take Zaltrap for several months, the price tag for 42 days of extra life would run to nearly $60,000. What they then decided to do was unprecedented: reject a drug just because of its price.
Dr. Peter Bach: We did it for one reason. Because we need to take into account the financial consequences of the decisions that we make for our patients. Patients in Medicare would pay more than $2,000 a month, themselves, out-of-pocket, for Zaltrap. And that that was the same as the typical income every month for a patient in Medicare.
Lesley Stahl: The co-pay.
Dr. Peter Bach: Right. 20 percent. Taking money from their children’s inheritance, from the money they’ve saved. We couldn’t in good conscience say, “We’re going to prescribe this more expensive drug.”
“It was a shocking event. Because it was irrefutable evidence that the price was a fiction.”
And then they trumpeted their decision in the New York Times. Blasting what they called “runaway cancer drug prices,” it was a shot across the bow of the pharmaceutical industry and Congress for passing laws that Bach says allow the drug companies to charge whatever they want for cancer medications.
Dr. Peter Bach: Medicare has to pay exactly what the drug company charges. Whatever that number is.
Lesley Stahl: Wait a minute, this is a law?
Dr. Peter Bach: Yes.
Lesley Stahl: And there’s no negotiating whatsoever with Medicare?
Dr. Peter Bach: No.
Another reason drug prices are so expensive is that according to an independent study, the single biggest source of income for private practice oncologists is the commission they make from cancer drugs. They’re the ones who buy them wholesale from the pharmaceutical companies, and sell them retail to their patients. The mark-up for Medicare patients is guaranteed by law: the average in the case of Zaltrap was 6 percent.
Dr. Leonard Saltz: What that does is create a very substantial incentive to use a more expensive drug, because if you’re getting 6 percent of $10, that’s nothing. If you’re getting 6 percent of $10,000 that starts to add up. So now you have a real conflict of interest.
But it all starts with the drug companies setting the price.
Dr. Peter Bach: We have a pricing system for drugs which is completely dictated by the people who are making the drugs.
Lesley Stahl: How do you think they’re deciding the price?
Dr. Peter Bach: It’s corporate chutzpah.
Lesley Stahl: We’ll just raise the price, period.
Dr. Peter Bach: Just a question of how brave they are and how little they want to end up in the New York Times or on 60 Minutes.
That’s because media exposure, he says, works! Right after their editorial was published, the drug’s manufacturer, Sanofi, cut the price of Zaltrap by more than half.
Dr. Peter Bach: It was a shocking event. Because it was irrefutable evidence that the price was a fiction. All of those arguments that we’ve heard for decades, “We have to charge the price we charge. We have to recoup our money. We’re good for society. Trust us. We’ll set the right price.” One op-ed in the New York Times from one hospital and they said, “Oh, okay, we’ll charge a different price.” It was like we were in a Turkish bazaar and…
Lesley Stahl: What do you mean?
Dr. Peter Bach: They said, “This carpet is $500″ and you say, “I’ll give you $100.” And the guy says, “Okay.” They set it up to make it highly profitable for doctors to go for Zaltrap instead of Avastin. It was crazy!
But he says it got even crazier when Sanofi explained the way they were changing the price.
Dr. Peter Bach: They lowered it in a way that doctors could get the drug for less. But patients were still paying as if it was high-priced.
Lesley Stahl: Oh, come on.
Dr. Peter Bach: They said to the doctor, “Buy Zaltrap from us for $11,000 and we’ll send you a check for $6,000.” Then you give it to your patient and you get to bill the patient’s insurance company as if it cost $11,000. So it made it extremely profitable for the doctors. They could basically double their money if they use Zaltrap.
“High cancer drug prices are harming patients because either you come up with the money, or you die.”
All this is accepted industry practice. After about six months, once Medicare and private insurers became aware of the doctor’s discount, the price was cut in half for everyone.
John Castellani: The drug companies have to put a price on a medicine that reflects the cost of developing them, which is very expensive and takes a long period of time, and the value that it can provide.
John Castellani is president and CEO of PhRMA, the drug industry’s trade and lobbying group in Washington.
Lesley Stahl: If you are taking a drug that’s no better than another drug already on the market and charging twice as much, and everybody thought the original drug was too much…
John Castellani: We don’t set the prices on what the patient pays. What a patient pays is determined by his or her insurance.
Lesley Stahl: Are you saying that the pharmaceutical company’s not to blame for how much the patient is paying? You’re saying it’s the insurance company?
John Castellani: I’m saying the insurance model makes the medicine seem artificially expensive for the patient.
He’s talking about the high co-pay for cancer drugs. If you’re on Medicare, you pay 20 percent.
Lesley Stahl: Twenty percent of $11,000 a month is a heck of a lot more than 20 percent of $5,000 a month.
John Castellani: But why should it be 20 percent instead of five percent?
Lesley Stahl: Why should it be $11,000 a month?
John Castellani: Because the cost of developing these therapies is so expensive.
Lesley Stahl: Then why did Sanofi cut it in half when they got some bad publicity?
John Castellani: I can’t respond to a specific company.
Sanofi declined our request for an interview, but said in this email that they lowered the price of Zaltrap after listening “to early feedback from the oncology community and … To ensure affordable choices for patients…”
Dr. Hagop Kantarjian: High cancer drug prices are harming patients because either you come up with the money, or you die.
Hagop Kantarjian chairs the department of leukemia at MD Anderson in Houston. Inspired by the doctors at Sloan Kettering, he enlisted 119 of the world’s leading leukemia specialists to co-sign this article about the high price of drugs that don’t just add a few weeks of life, but actually add years, like Gleevec.
It treats CML, one of the most common types of blood cancer that used to be a death sentence, but with Gleevec most patients survive for 10 years or more.
NAT’L ONCOLOGISTS GROUP TACKLES SPIRALING DRUG COSTS
Dr. Hagop Kantarjian: This is probably the best drug we ever developed in cancer.
Lesley Stahl: In all cancers?
Dr. Hagop Kantarjian: So far. And that shows the dilemma, because here you have a drug that makes people live their normal life. But in order to live normally, they are enslaved by the cost of the drug. They have to pay every year.
Lesley Stahl: You have to stay on it. You have to keep taking it.
Dr. Hagop Kantarjian: You have to stay on it indefinitely.
Gleevec is the top selling drug for industry giant Novartis, bringing in more than $4 billion a year in sales. $35 billion since the drug came to market. There are now several other drugs like it. So, you’d think with the competition, the price of Gleevec would have come down.
Dr. Hagop Kantarjian: And yet, the price of the drug tripled from $28,000 a year in 2001 to $92,000 a year in 2012.
“They are making prices unreasonable, unsustainable and, in my opinion, immoral.”
Lesley Stahl: Are you saying that the drug companies are raising the prices on their older drugs.
Dr. Hagop Kantarjian: That’s correct.
Lesley Stahl: Not just the new ones. So, you have a new drug that might come out at a $100,000, but they are also saying the old drugs have to come up to that price, too?
Dr. Hagop Kantarjian: Exactly. They are making prices unreasonable, unsustainable and, in my opinion, immoral.
When we asked Novartis why they tripled the price of Gleevec, they told us, “Gleevec has been a life-changing medicine … When setting the prices of our medicines we consider … the benefits they bring to patients … The price of existing treatments and the investments needed to continue to innovate…”
[Dr. Hagop Kantarjian: This is quite an expensive medication.]
Dr. Kantarjian says one thing that has to change is the law that prevents Medicare from negotiating for lower prices.
Dr. Hagop Kantarjian: This is unique to the United States. If you look anywhere in the world, there are negotiations. Either by the government or by different regulatory bodies to regulate the price of the drug. And this is why the prices are 50 percent to 80 percent lower anywhere in the world compared to the United States.
Lesley Stahl: 50 percent to 80 percent?
Dr. Hagop Kantarjian: 50 percent to 80 percent.
Lesley Stahl: The same drug?
Dr. Hagop Kantarjian: Same drug. American patients end up paying two to three times more for the same drug compared to Canadians or Europeans or Australians and others.
Lesley Stahl: Now, Novartis, which makes Gleevec, says that the price is fair because this is a miracle drug. It really works.
Dr. Hagop Kantarjian: The only drug that works is a drug that a patient can afford.
The challenge, Dr. Saltz at Sloan Kettering says, is knowing where to draw the line between how long a drug extends life and how much it costs.
Lesley Stahl: Where is that line?
Dr. Leonard Saltz: I don’t know where that line is, but we as a society have been unwilling to discuss this topic and, as a result, the only people that are setting the line are the people that are selling the drugs.
*****
Robert I: Nice to see a comment from you. Thanks for continuing the cancer conversation by adding in some really important information that people need to know. I am familiar with the cholesterol levels being lowered every year. I have been trying to find a good write about that to post. It’s crazy and sickening how big pharma is in bed with the doctors, the ones who are supposed to care about our health, and they are basically making money by taking advantage of people wanting to live.
Readers: Between thugs with guns and greedy doctors, we can’t seem to rely on people whose jobs are supposed to be caring for our well-being. But what we can rely on is our own voice and our vote. What I wish for everyone to know is that their vote does count. We see it time and time again, how when we don’t exercise our right to vote, at best, we give our power to those that don’t have our best interest in mind, and at worst, they simply don’t care because money is more important. In case you’re wondering whom I am speaking of, it is the repub party.
Why would anyone let someone else control their livelihood, well-being, body…whatever? I certainly am not handing over that power. I encourage you to do the same and make sure that your friends and family are on board too. I can’t stress it enough and if you’re tired of me saying it…well, too bad – let’s do it so I don’t have to say it anymore. Make your voice heard. Make your vote count. Take your power back. VOTE THIS NOVEMBER.
Lucy, ST, Evelyn: I found that segment fascinating as well. And I loved that part about the dog’s eyes too. I have always connected with Lucy through her eyes and I just can’t seem to give her enough kisses throughout the day. But learning that “When dogs are looking at you they are essentially hugging you with their eyes,” really left me with such a sweet, warm feeling. I am now looking at Lucy a little differently.
I love this photo of Lucy with her “Chewy Vuitton” shoe given to her by my sister-in-law. :)
♥♥♥
Peace & Love…
Lastly, greed over a great story is surfacing from my “loyal”(?) readers. With all this back and forth about who owns what, that appears on my blog, let me reiterate that all material posted on my blog becomes the sole property of my blog. If you want to reserve any proprietary rights don’t post it to my blog. I will prominently display this caveat on my blog from now on to remind those who may have forgotten this notice.
Gratefully your blog host,
michelle
Aka BABE: We all know what this means by now :)
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October 6th, 2014 at 10:36 am
Thank you for the reminder of why I waited so long to get to a doc, it’s their general greed, misinformation and lack of true knowledge …
Re: cancer … I wouldn’t take any of this crap without throughly reading this http://www.cureyourowncancer.org/exposing-the-fraud-and-mythology-of-conventional-cancer-treatments.html and researching every last tidbit in this article bc THAT not a doc could save your life.
Chewy Vuitton, that’s adorable and so is Lucy. Elke was a serious eye hugger, miss my girl.
Luv, Zen Lill
October 6th, 2014 at 12:05 pm
On another un-related topic (just today) …
http://www.msn.com/en-gb/lifestyle/relationships/male-feminist-a-spoof-magazine-for-men-who-really-care/ar-BB7NAc3
Closing para: However, several online commentators have questioned whether it is in fact possible for men to be feminists at all . Writing on the website for the National Organisation for Men Against Sexism, Brian Klocke said: “Although I believe that men can be pro-feminist and anti-sexist, I do not believe we can be feminists in the strictest sense of the word. Men, in this patriarchal system, cannot remove themselves from their power and privilege in relation to women. To be a feminist one must be a member of the targeted group (i.e a woman) not only as a matter of classification but as having one’s directly-lived experience inform one’s theory.”
Yea … true …
- ZL
October 6th, 2014 at 3:11 pm
Michelle. your dedication to motivating others to get out and vote is directly appreciated.
October 7th, 2014 at 5:59 am
“Sprycel and other top-tier cancer drugs cost twice as much in the United States as they do in parts of Europe, China, Canada and the United Kingdom, where the government sets a limit on pricing.” Guess the USA is all about PROFIT, even at the cost of the lives of cancer patients. Disgusting is all I can say.
October 7th, 2014 at 6:01 am
When it comes to medicine people should not have to make the choice of buying medicine or buying food. It has nothing to do with money and power. The rich can still live in the mansions and drive fancy cars.
October 7th, 2014 at 6:01 am
But everything in medicine was so perfect before Obamacare.
October 7th, 2014 at 6:02 am
I have leukemia and let me tell you there are so many people who have no clue. I have one treatment that costs $32,000. per session and 3 sessions. My out of pocket has gone more than double and with a 20% co- insurance that is $6400.00 per treatment.
Co- insurance is a not insurance at all. It’s an addition to your co-pay. The companies CEO’s and other big shots may care but it’s for a profit. Everything is profit driven. My doctor told me he would take what ever the insurance gave him and I paid no office visit.
So people on the outside of corporations like doctors, nurses, healthcare personnel are our only hope in a battle more against the profit machine than the cancer we face. Plus when I tack on the costs for meds for my degenerative disc disease it can make you cry. Oh one last thing- insurance companies can bargain prices down to less than 20%. Look at your EOB’s.
October 7th, 2014 at 6:03 am
I also take Sprycel for my leukemia. I have insurance so I only have to pay $30 copay but the medicine costs $8700 for a 30 day supply. That’s $290 a day, everyday! I’ve been taking it for 6 yrs. It’s scary that people can’t have something that would keep them alive.
October 7th, 2014 at 6:06 am
Betty#4, And it’s illegal for patients to import drugs even if they have a prescription. They don’t care about people only profits.
October 7th, 2014 at 6:09 am
Betty#4, The problem is more than just profit, it is also the American populations expectation that they can have any therapy they want and it won’t cost anything. Compounding this are the malpractice insurance claims that are paid out that need to ultimately be paid by consumers. We have created a ‘free-market’ heathcare system that is so dysfunctional it is a total joke. The companies that make billions of dolalrs don’t want to implement a national healthcare program because it will limit the prices they can charge.
As an American now living in a national healthcare country, I understand totally how tough decisions about who gets medication and who doesn’t is a real choice. Should someone who makes minimum wage working in a job that doesn’t really contribute much to society get a drug that costs $100K per year? It may seem callous, but there is not a universal right to get whatever medical care it takes to keep you breathing.
Even though I have worked in healthcare for over 30 years, I will not impose my ‘right’ of healthcare if my resulting contribution in social and economic terms cannot justify the cost. And I do not mean just the ‘warm-fuzzy’ your family gets from having you around, but quantifiable contributions. In a world that is overpopulated by 3 Billion people, we need far fewer for our species to survive, not to keep everyone consuming more goods.
October 7th, 2014 at 6:12 am
Scott#5, If lead scientists were the ones getting the million dollar bonuses and not the CEOs it would be more understandable.
October 7th, 2014 at 6:18 am
Zen Lill#2, the way I see it is a misogynist may see it that a man can not be a feminist because the misogynist needs the position of power today’s society gives him to continue practicing his hateful ways against women. It is the same for any racist and anti gay person.
We are born racists and bigots. It is an acquired taste.
October 7th, 2014 at 6:20 am
Vern#9, Yes, it’s technically illegal to import, but over a million Americans each year still do so. For many, it’s the only way they can access the drugs they need at prices they can afford.
October 7th, 2014 at 6:21 am
When I got my bill for some cancer treatments earlier this year I told the clinic that they can get $50/month until I’m dead because I’ll never b able to pay it off in full – & I have health insurance!
Just imagine what it must be like for those who have no insurance…DISGRACEFUL SITUATION. The pharmaceuticals are just like rapists – taking advantage of our situation, & trying to profit from patient’s circumstances.
October 7th, 2014 at 6:22 am
Why would they find a cure for cancer when they can make so much money treating it.
October 7th, 2014 at 6:24 am
Kris#6, The one thing that should have been the major factor of the law.
October 7th, 2014 at 6:29 am
Did you know that we are one of the few nations that allow direct advertising of prescription drugs to the public.
October 7th, 2014 at 6:30 am
Isn’t that what America is about? We would be a socialist or communist country if everyone was entitled. What good is money and power if you can’t use it? America has never been about what is fair (freedom yes, fairness no).
October 7th, 2014 at 6:31 am
Vern#16, As if Repubs would allow it.
October 7th, 2014 at 6:32 am
Kris#19, Or we could just as all them at the same time.Stop making it party vs party. It’s not supposed to be that way.
October 7th, 2014 at 6:33 am
Lord Have Mercy….I first heard about “Thirty tiny pills for $10,000…” from Lola Hardaway. I could not believe it then and now here it is again and I can not imagine how anyone could survive thinking about how they can afford Sprycel. This is not right!
October 7th, 2014 at 6:34 am
Vern#20, Republicans have coast to coast radio/TV coverage of right wing hosts 24/7 a week to make sure it is that way.
October 7th, 2014 at 6:36 am
Gee, and what has happened to the rest of drug prices? According to the CPI, most have doubled or tripled depending on the need or desire for the particular cancer drug.
October 7th, 2014 at 6:37 am
Kris#22, So why don’t the Democrats do the same? Instead of taking about the other party why don’t Dems talk about unifying more to fight back? It’s why I’m an independent.
October 7th, 2014 at 6:39 am
Vern#24, Yes, they definitely could fight for what the Democratic Party stands for more often–they would gain more respect.
October 7th, 2014 at 6:52 am
I didn’t know this until I saw it on The View this morning. I found it interesting, but it might be old news to some of you. A Guam name is on our money.
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Rosa “Rosie” Gumataotao Rios (born July 17, 1965) is the 43rd and current Treasurer of the United States. Rios, a first generation Mexican American, was born to Guadalupe Rios. She is the sixth Latina to occupy the office, the third consecutive Californian, the third consecutive Hispanic female to do so, and following Anna Escobedo Cabral is the second consecutive Mexican-American to hold office.
In 1983, Rios attended Harvard University. She graduated with a Bachelor’s degree in Sociology and Romance Languages and Literature.
Rios was sworn in on August 20, 2009. Her full name will be printed on all U.S. bills.* As it includes her husband’s name of Gumataotao, it marks the first time a Chamorro name appears on U.S. currency.
Rios is married to Guamanian Jose Diaz “Joe” Gumataotao, Jr., an information technology executive. They have two children- Joey (born 1996) and Brooke (born 2000) and reside in Potomac, Maryland.
Rios’ confirmation caused excitement on Guam, where her in-laws have a political presence. Her husband’s uncle, Vicente D. “Ben” Gumataotao, is the mayor of the commercially important town of Piti, while his first cousin, Joanne Camacho, is the wife of former Governor of Guam Felix Perez Camacho. Another cousin is Guam Superior Court Judge Vernon Perez and Guam Chamber of Commerce, board directors Valentino Gumataotao Perez. First Lady Camacho called Rios’ elevation a “giant step forward for minorities in the United States and insular areas.”
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Hafa adai
October 7th, 2014 at 7:00 am
Michelle, someone has been trying hard to keep traffic off you blog. In the past 3 days I have gotten every excuse possible denying me access to your blog. But this one was especially crazy. HTTP Error 500-13 – Server too busy.
October 8th, 2014 at 9:02 am
[…] Scott: I agree with /SB, only I will take it a step further and say that they do have the cure for cancer and it is locked up in some safe place where no one can find it. […]