Healthy Skepticism Library item: 1985

Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.

Publication type: news

Spiralling drug costs threaten health care
The Gazette ( Montreal) 2005 Aug 7

Notes:

Ralph Faggotter’s Comments: This article points to a nightmare future in which new drugs of comparatively marginal benefit could gobble up the shrinking health budgets of nations, leaving little money for basic health care needs.

Full text:

Spiralling drug costs threaten health care

The Gazette

Monday, August 08, 2005

That rumble in the fiscal jungle of Canadian medicare last month was the
sound of one province after another jumping onto the Herceptin
bandwagon. With news reports now suggesting the new breast cancer drug’s
benefits have been overstated, and British regulators worried about
harmful cardiac side effects, Canadians shouldn’t be surprised to see
the provinces engage in some collective backtracking.

Certainly, a reasonable case can now be made to de-list Herceptin from
provincial health plans. It isn’t just that Herceptin’s true usefulness
is still a matter of dispute. There will always be uncertainties with
new drugs, one way or another. It’s also a question of money. At $35,000
to $45,000 per patient-year of treatment, full medicare coverage of
Herceptin would cost Canadian taxpayers $150 million a year. And only
one in five breast-cancer patients would get to use it, since it is
designed to help only the 20 per cent of all such patients who happen to
over-produce a certain protein.

So think of it: What we have in Herceptin is a new niche drug that would
cost, over six years, roughly the same amount of public money that has
been committed to construction of the new McGill University Health
Centre – a dual-campus, state-of-the-art hospital in a major Canadian
city.

The frightening thing about Herceptin, from a fiscal point of view, is
that it is just one of a growing number of expensive niche drugs coming
on the market.

Thanks to advances in genetic research, even the rarest of medical
disorders now have their own specialty drugs with five-digit price tags.

Taken together, rising drug costs in the wake of the mapping of the
human genome are practically certain to exceed the tenfold rise since
1980 that Canada has experienced.

What that means is we have to start acknowledging that escalating drug
costs might well represent the single most serious long-term challenge
to our medical-care system. We need, therefore, a new fiscal vision for
the role of prescription medication in health care.

For starters, we will need to make sure our regulatory bodies do a good
job of making sure that clinical trials are based on solid science. That
might sound self-evident, but a 2003 CBC Marketplace investigation found
evidence of flawed trials getting rubber-stamp approval because
government scientists had too much on their plates.

Secondly, and most importantly from a cost point of view, the federal
government should be prudent, to say the least, about the fashionable
idea of national pharmacare modelled after the comprehensive Quebec
plan, created in 1996 for people without private insurance. Since then,
the Quebec plan has gone from a balanced budget to a $1.6-billion
deficit – with no relief in sight.

Instead of subsidizing each and every pill, it might make better sense
from a public-insurance point of view to operate a much more streamlined
“catastrophic” plan, as some people have proposed.

Let people pay for their own codeine tablets. But let’s also make sure
nobody in this country goes broke to get medication that is costly but
essential.

C The Gazette (Montreal) 2005