Drug Use and Choices by Society

Today all of us are continually bombarded by the media on various subjects. They always try to appeal to our emotions rather than our sensibilities. One of the most emotional problems we deal with in medicine within our families is cancer. Whenever we hear that a new cancer drug is not approved, we are apt to get up in arms because we feel our government is withholding treatment from a poor patient who may have exhausted all currently available manners of treatment and the last hope seems to be a new experimental drug.

None of us like to think that decisions about our health care are based upon economics, but the truth of the matter is they are. Always when looking at a treatment the cost must be taken into account. I am going to use thinking by the UK for this example so you know all government agencies go through these same thought processes. It does not only happen in the United States. In May 2010 the National Institute for Health and Clinical Excellence (NICE) decided not to support the drug sorafenib (Nexavar) for treatment of primary cancer of the liver. The price of the medication was $42,500 per course of treatment.

Physicians and citizens reacted somewhat angrily. They said NICE may save money but it doesn’t save lives. They did not mention that Nexavar did not save lives either. It simply prolonged lives 2.8 months. We must always remember these medications are pushed because Big Pharmaceutical Companies may have spent millions of dollars developing these new cancer drugs and they want a return on their investment.

Also the oncologists who may push these medications make their living giving them to patients. If you look at the potential life threatening side effects of medications such as these you would wonder why our NIH even takes the time to evaluate them.

Yes, as with many things in medicine it gets down to the almighty dollar.