When Beating Cancer Costs $17,000 A Month, What does One do?

When Kristen was diagnosed with   incurable breast cancer, her first though of course was of her 8 year old daughter. The South Dakota woman searched for experimental treatments and with that, sought an unproven approach where doctors sought drugs based on the genes in patients tumors. The drug was based on the ever-changing DNA of cancer cells. Kristen responded well to the  therapy, better actually than anyone could have hoped. At present, her cancer has  gone into hiding and the tumors? Well they are no longer visible. The researchers call the approach precision medicine and the insurance company? They call it experimental. With that, the insurance companies that never want to pay for anything only covered a portion of the drug forcing Kristen to be on her own for the rest of the tab. So now, Kristen has to make the terrible choice, stop taking the drug that costs nearly $17,000 per month, yes, per month! or, pay out of her own pocket. So, the question arises, does Kristen take the drug and hope to live to see her eight year old daughter graduate from high school and then college, and for her to marry? or, does she stop taking the drug that is causing devastating financial ruin?                                                                                                                                                                                Precision medicine is one of the most celebrated areas in cancer research But the high cost keeps the drug from many. Many doctors say that patients who pay for the drug on their own, will be on the financial ruin for decades. Though the technique is relatively new, there are many who have been helped by this new technology. Medicare announced in March that people 65 and older will pay for genomic testing for people with advanced cancers. A decision that could cost 2.5 billion in federal health health care costs. Of course, few private insurers cover the costs. I fairness to what many feel are gougers and only interested in profits, the drug makers have been generous allowing Kristen to take rotating cocktail of these experimental drugs for free because of her income level. Moreover, though thousands of cancer patients have seen positives from these drugs, the insurance companies say that the costs aren’t their only concern. They argue that there isn’t enough evidence that they work, even though their claims are unsubstantiated. Of course without the insurance, most cancer patients have given up as they feel there is no hope with the affordability of the drugs. The WONDERFUL news is that after hearing Kristen’s story, Astra Zeneca had agreed to providing their drug Lynparza to her for free.                                                                                                                                                                                                                                                                                            In conclusion, my commentary on this is a valid one as I have had relations with both insurance companies and, drug making companies. Unfortunately, the drug companies have received a bad name in their reputation for high priced drugs that are out of the reach of most patients who desperately need them, but, the public is misguided. While many of the leading drug making companies do charge exorbitant prices, they have shown that they do have compassion by giving reduced drugs and in many cases like Kristen’s drugs for free. What most of the public doesn’t realize is that research on new drugs costs the industry millions of dollars over many years after which, only to see the drug fail after the FDA rejects it. These costs, are passed on to consumers on other drugs to insure compensation for the company. The insurance companies of course are an entirely another matter. There are hundred of horror stories on the web that insurance companies have  either on a technicality dropped patients from their policies leaving them high and dry and on their own. My own experience with insurance companies in particular Allstate refused to pay for water damage that I had that wrecked the house. I sued them for double damages. They showed that they could have cared less. The adjuster was a bigger criminal than the company. many policy holders do not know that once you sign a proof of loss sheet where you agree to accept their financial settlement, most times,the settlement is much lower than what you would have received with a private adjuster. Whats up? well the company gives the local office a settlement and if that settlement is more than what you agreed to as you have no way of knowing, then they keep the rest! Nice business practices hey? These are the same companies that proudly display amnesty for your car accident when you have paid them a policy for that situation. I have had instances where they only paid a portion for the tires that were stolen from my car. Others,get their cars prorated instead of getting the full amount for a car that is totaled in an accident. So, some of the biggest criminals in business are insurance companies not the drug companies.  Insurance works this way, you are in need of peace of mind, you purchase a policy, the insurance company underwrites it and you pay a monthly premium only to find out that you will be screwed in the long run from their less than stellar practices, yet, when people try to defraud them, they get huge fines and jail time.  While the industry of drug companies many times are accused of improper dealings, many give to insure the well being of patients in dire need. maybe people should investigate who the real dishonest crooks are, drug companies or insurance companies. The research is there go investigate for yourself. As for Kristen, she is doing ok so far.


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