a female cancer patient with no hair, unconventional approaches to treating cancer

The hottest new cancer treatment is called CAR-T. It stands for chimeric antigen receptor (CAR) T-cell therapy. Many world class medical centers have gone all in on CAR-T cancer research. That’s because there is great hope that this new form of personalized immunotherapy could represent a dramatic improvement in hard-to-treat cancers. Is CAR-T worth almost half a million dollars?

ALL Treatment

Imagine for a moment that someone you loved was diagnosed with a deadly cancer called acute lymphoblastic leukemia (ALL). This is a blood cancer. The bone marrow churns out way too many immature white blood cells (lymphocytes). They are unable to do their job fighting infection. As more and more leukemia cells are produced, fewer healthy lymphocytes can be made. Symptoms include easy bruising, fever, joint pain, swollen lymph nodes, fatigue and weakness.

In the past, treatment for this kind of leukemia has involved potent chemotherapy drugs and powerful corticosteroids (dexamethasone or prednisone). There are additional drugs that sometimes help such as Gleevec (imatinib) or methotrexate. The cure rate for adults is usually around 40 percent.

If this kind of leukemia relapses the prognosis is not good. When children or young adults experience a return of ALL, their anticipated lifespan is measured in months, not years.

CAR-T for ALL: Is Kymriah Worth $475,000

What price do we put on a life? That seems to be the question the pharmaceutical industry is now asking. There is tremendous excitement about CAR-T because the early word on the street is that it could represent a cure for some people. This new cancer therapy is the first FDA-approved gene treatment for leukemia. Novartis has named its CAR-T treatment Kymriah.

This therapy involves harvesting T cells from the patient. These specialized immune cells are then modified to produce chimeric antigen receptors (CARs). The CAR-T cells are then allowed to multiply. When there are millions and millions of CAR-T cells they are infused back into the leukemia patient’s bloodstream where they are supposed to home in on the cancer cells and kill them. This sort of immunotherapy has many cancer researchers excited because they have seen results in some patients that have been nothing short of miraculous.

An Inside Story on Drug Prices:

Decades ago an executive at one of the country’s leading pharmaceutical companies confided to us that the industry was facing a crisis with regard to drug pricing. The first AIDs drugs were becoming available and companies were charging what seemed like outrageous prices.

The initial price tag for AZT in 1987 was $10,000 a year. That was considered shocking. AIDs activists and public health experts were up in arms. Civil disobedience protests over the price forced the company to lower the price to $8,000 a year.

The Impact of Push Back:

Our insider into drug company negotiations told us that he and other executives sat around a table in the 1980s and discussed pricing in general and cancer drug prices in particular. These pharma folks were taken aback by the public outcry over the price of AIDs drugs.

They admitted to themselves that if a company came up with a cure for cancer it would have to be very cautious about the price it charged. There was even a suggestion that the industry would have to give away such a miraculous medicine. Otherwise, the entire pharmaceutical industry might be tarnished. The rebellion over the cost of AIDS drugs suggested to these various executives that the public would not stand for price gouging. That was then.

Today, drug companies routinely charge anywhere from $100,000 to $150,000 for new immunotherapy cancer drugs. We suspect that the $475,000 price tag for Kymriah is a trial balloon. There are many other companies researching CAR-T therapies for other cancers. If Novartis can get away with charging nearly half a million dollars, then other companies are likely to see that as the new benchmark, too.

Can We Afford New Cancer Drugs Like CAR-T?

Even if someone has great insurance, there are collateral expenses associated with CAR-T. Patients often have to stay close to the medical center for weeks or months after they get their CAR-T infusion. That’s because side effects of this therapy can be life threatening.

The immune system sometimes goes wild. A massive release of chemicals called cytokines can trigger high fevers and very low blood pressure. Serious infections are another worrisome complication. Brain swelling can lead to seizures and other neurotoxicity. These adverse reactions are often treated with large doses of corticosteroids, which also carry significant side effects.

Insurance companies that agree to pay half a million dollars for CAR-T therapy will doubtless raise their premiums. Patients who do not get approval from their insurance companies will have to face a terrible dilemma: Beg or borrow hundreds of thousands of dollars or watch a loved one die. In our opinion, that is unconscionable.

What if There Were a Cure for Alzheimer’s Disease?

Most people have been touched by dementia. Have you watched helplessly as a friend or family member slowly descended into forgetfulness. What would you pay to keep that person out of a nursing home? What if we could keep that individual from disappearing down the rabbit hole entirely?

We suspect that the first truly effective medicine against Alzheimer’s disease might come with an unbearable price. The drug company would likely charge more than $100,000 a year. It would justify the cost on the grounds that nursing home care can cost almost that much, if not more.

Multiply $100,000 times 5 million people with Alzheimer’s disease. That comes to:

$500,000,000,000,000

That’s theoretical. But it is more money than any country could afford.

Now consider the cost of cancer drugs at $500,000 per treatment. How long can we sustain a health care system with prices like that? We suspect that the entire system will implode within a few years if we do not get costs under control. Breakthrough drugs like CAR-T are great…if they are affordable. If our entire health care system sinks under the weight of such advances, we’re all in trouble.

What Do You Think?

We would love to hear from you. Are new cancer treatments worth hundreds of thousands of dollars? We all want new and better cancer therapies. Can we afford them? Share your thoughts in the comment section below.

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  1. DSF
    Lakewood, NJ
    Reply

    I agree with many of the previous comments, however, as a grateful recipient of free drug treatment with Imbruvica from Johnson & Johnson which would normally cost over $100,000.00 per year I believe all the rage.

    Against all the pharmaceuticals is unfounded. That is not to say there are no unscrupulous companies who take advantage of their position. I’m sure everyone is aware of the costs and many years of developing, testing and bringing a new drug to market at little or no cost to taxpayers.

  2. Chris
    Allen Texas
    Reply

    Sounds like the government is purposely “thinning the herd.” They allow poisons into our food, and turn a blind eye to the unhealthy way our meat, chicken and fish is raised and prepared for sale. Unhealthy items are allowed into the country from China. And now they produce medicine that only the Uber rich can afford. Big Food and Big Pharma are the people running this country. After reading this article, I will never give another penny to medical research. They already get my tax dollars. As someone else mentioned up-thread, we generously donate money to fund research for killer diseases only to find out that we cannot afford the drugs when our or a family loved one needs it. Like others, I have no plans to extend my life when death comes a knocking. I carry a DNR card.

  3. Bill
    Newtown, PA
    Reply

    $475,000 for a possible extension of life is not a cure, it’s a money scam, being proposed by an unscrupulous company.

  4. Sue
    Virginia
    Reply

    The health care system in this country needs reform from the ground up. The health insurance system creates bizarre arrangements where the price of care and medications seems to be based on what the pharmaceutical companies, among others, think they can get away with. The insurance companies themselves add no tangible value to health care – they are profit-driven middle men. Those who have insurance may receive outrageously expensive care that improves quality or length of life very little, if any.

    Meanwhile, some of those with no insurance can’t even afford basic care to prevent illness. The pharmaceutical companies advertise relentlessly on television to encourage patients to request the latest expensive medications – avoiding honest disclosure of how much patients are actually likely to be helped. Some physicians are also guilty of pushing patients to accept medications and other treatments that are dubious in benefit but will make the physician richer.

    To make matters even worse, throw in the lawyers who rake in the money suing anyone they can. There is no reason this rich country can’t figure how to bring sanity into this health-care nightmare – but too many politicians on both sides are more concerned with whipping up animosity to increase personal power than cooperating to fix this shameful mess.

    The solutions aren’t easy, but there has to be a way to make it fair to everyone, including drug companies and medical care providers – unfortunately there are too many special interests who care nothing about fairness and reason.

  5. Nancy
    Romeoville, IL
    Reply

    CHemo treatments average $500,000 per treatment plan, it’s just spread out & it doesn’t cure the disease. CAR-T Is a cure so in the long run a cheaper option.

  6. Renate
    Chicago
    Reply

    I hope Trump drains the swamp in government and in drug companies.

  7. William
    Springfield, MO
    Reply

    Much of the background science for this kind of treatment was done with government grants through the NIH. The contribution of the government should be taken into account when the pharmaceutical company sets prices- perhaps they should have to repay the government grants.

  8. Frances
    Reply

    Well yes, it’s all about dollars and cents, of course. That doesn’t mean that the conventional cancer treatments are cost-free – or offer a large chance of cure, in most cases. There may not be such a huge gap in sheer money terms. Though of course the cancer business is a gigantic part of our national economy, which is another way of thinking about it in dollar terms.

  9. Carol
    Winston Salem, nc
    Reply

    For myself, never spend that much on cancer treatment. For my son, would be more than all I own, so no from this family.

  10. Cheryl
    TX
    Reply

    I would like to see the breakdown of the sales and profit margin on the cancer drug. And drug companies don’t let us see this information. Since the drug companies use a formula based on what they think they can get away with instead of a fair profit based on the costs of the drug, we could then see that the drug is significantly overpriced. Shame on the drug companies (as usual); they are what’s wrong with our health system. And don’t even get me started on their salaries.

  11. Hank
    Reply

    The drug companies have a sweet racket. The government funds and develops the drugs, then they turn it over to private companies to gouge the public.

  12. Cindy M. Black
    Seattle, WA
    Reply

    The outrageous prices of such drugs is, simply, the CRUELEST AND MOST VICIOUS FORM OF BLACKMAIL ever foisted on humans. For humans already down and suffering, it kicks them in the gut, saying: “We just put a big pricetag on your life. What, you can’t pay it? Fine, then you die. Bye!” Of all the freakin insults. Who the hell is stupid enough to believe they are just recouping costs? I’ve got a bridge to sell them.

  13. Lynn
    San Jose, CA
    Reply

    I think this is outrageous. I am ashamed to live in a country that would let people die because they cannot afford those ridiculous prices. The drug companies, especially with all the stock they sell are looking for money not saving lives.

    • Mary
      Reply

      To be honest with all of you. I have come to think that yes, all of the these so called drug makers do want to see that happened. Just to see patients died. They feel one less person to not worry about.

  14. Renee V
    Florida
    Reply

    What I don’t understand is why can’t these companies look at the success of Walmart and see the logic in Walmart’s philosophy of doing business – lower prices increases volume of sales. Say, if only 10 people can afford $475,000, maybe 1000 could afford $475!!! More people helped, same amount of money made. I realize that is a slight oversimplification and there is more to it than that, but the principle is sound and could be applied in a logical manner to the pharmaceutical industry.

  15. mike
    sarasota
    Reply

    Do we know what the actual cost of producing the drug was/is and what the estimated return on the investment to the company at this price level would be???

  16. Paul
    WA
    Reply

    The federal government needs to change the laws to ensure that there is competition in all health-related businesses. If that occurs, and the price is still $475,000 it is a fair price, and we all have to decide just what our life, or the lives of loved ones, is worth. The tooth fairy does not pay for everything that we need in life. We have a government which is going ever more deeply in debt paying for things that some or all of us believe we need. There is greed amongst us, and it is called the profit motive. Businesses work very hard to be the most efficient in order to beat the competition. Winning this race is is called success. The appropriate role of our government is to ensure that competition is alive and well so that the selling price reflects the lowest price at which a company is able to produce the product and yield a profit which enables it to stay in business and develop more and better products.

  17. Kay
    NC
    Reply

    Remove the expensive TV ADDS. Money saved could help reduce costs.

  18. Marilee
    Reply

    I just watched a wonderful TV series about advanced treatments being developed at the NIH, which included treatment with CAR T cell therapy. What wasn’t mentioned in the series, was the posible release of the treatments they’re developing to corporate interests, outside the NIH. If the NIH, a government agency, is developing CAR T protocols for treatment, do the money grubbing pharmaceutical companies get to take that research and then co-opt it themselves, turning the research into their own cash cows as desperate cancer sufferers must pay for the treatments?

    • Sally
      Houston, TX
      Reply

      Could you please tell me what the name of the TV series you watched (and mentioned in a comments on a recent People’s Pharmacy weekly newsletter) about advanced treatments that are being developed at the NIH is? On Netflix, Amazon or where? Thank you!

  19. Rick
    Tampa, FL
    Reply

    We tend to regard announcement such as this with great hope. At the same time, please tell me the
    *real* benefits of the statin drugs. The above mentioned drug is brought to you by the same folks.
    They will and have done *anything* to part you from your money.
    Sad to say, I was once a naive research scientist……

  20. Allan
    Penrose, NC
    Reply

    What did we do five years ago? When our time came, we died. But we still on average lived much longer than Americans 200 years ago. A large part of the increased cost of medical care is because people are living longer than ever before. I am 80, and I still think we may be working too hard keeping people alive. Death is inevitable. Maybe we should just relax a little and let it come, rather than spending millions for a couple more years. In a nursing home. Contributing very little to anyone. Several people I know have asked why they were still here — their useful time was up, and they wanted to leave.

  21. Gerri
    Southport,NC
    Reply

    Of course the drug companies’ prices are too high. Of course only the super rich can afford the out-of-pocket costs, and of course thr health care system will never have enough money to pay for this cancer drug or all the other drugs that we need to treat alzheimers, autism, autoimmune disorders, diabetes, heart disease etc.

    How about we take a look at the reasons that we have a need for all these drugs? How about the numbers of meds folks are taking just because they are “covered”. How about the poisons in our foods and our environment ? How about the lack of personal responsibility i.e. Smoking, poor eating habits , lack of exercise? Let’s examine the roles played by big pharma, big agribusiness, big fertilizer companies , the FDA and the interaction among all these entities. Nuff said.

  22. MS
    Atlanta
    Reply

    In January I was diagnosed with stage three cancer. Half way through treatment I was so depressed and having severe neuropathy.. I could no longer walk without aid. I decided quality was better than quantity of life. I stopped treatment.
    I’m receiving acupuncture and Chinese herbal treatment. I feel wonderful and walking unaided.
    We need to look outside the United States for cancer treatment.

    • Elsbeth
      Sequim, Washington
      Reply

      There are many tens of thousands of people turning to alternative cancer therapies that have worked for many years. Ty Bolinger has produced a series of streamed documentary episodes that have been aired for free, called The Truth About Cancer, in which he interviews dozens of experts, oncologists, naturopaths, health experts on other choices and lifestyles. I am floored how many continue to take the terrified stance that there is no choice and we are all held hostage by Big Pharma!

What Do You Think?

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