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American Medicine

Would you ever expect a doctor to protest on your behalf regarding the cost of a medical treatment? Well you should, because they do! Aflibercept (marketed as Zaltrap), a new medication that is effective in cancers of the colon and rectum, is extremely expensive; the estimated cost of this treatment is $11,063 per month. This extraordinarily high cost is not only an unmanageable burden for patients, but also affect the health care system as a whole, and some doctors are speaking out, going so far as to publish an OpEd in the New York Times. As a result of this OpEd, and the action of Memorial Sloan Kettering Medical Center refusing to approve aflibercept for therapy of colon cancer patients, the manufacturer reduced the cost of the drug by approximately 50%.

The implications of this are important: in the United States, we have laws that specifically prevent our government from trying to negotiate the costs of drugs.  However, it appears that in this case at least, physician objections can have a favorable effect on pharmaceutical companies to get them to reduce the price of their drugs for patients and insurance companies.  This is the first case of academic physicians objecting to high cost of drugs with a beneficial result on drug pricing for patients. It may become a seminal event and be copied with other very expensive medications.

In the mean time (while many necessary medications and medicines remain exorbitantly expensive), here are a few things to consider:

• Before accepting any type of therapy, discuss with your physician and/or pharmacist how expensive that medication will be
• Discuss with your physician if there are less expensive alternatives
• Discuss with your physician if there is a patient support program offered by the pharmaceutical company, or by foundations that can help to reduce your costs of expensive medications
• Ask your physician to write a letter objecting to the high cost of medications if you consider the cost of the medication to be burdensome
• Ask your Senator, Congressman, and the President to take steps to reduce the price of expensive medications so they can be more affordable, and be more effectively used by you and other patients.

For more information on finding affordable medications, see Chapter 30 “Finding Affordable Medications” in my new book Surviving American Medicine.