Yahoo Lifestyle Why Does The Same Drug Cost One Cancer Patient 196 Times More Than Another
They both have cancer.. The same drug may save them, so why does it cost Anita $452* but Jess $88,800*? Photos: marie claire
Australia has one of the highest cancer rates in the world, yet for some patients, the latest drugs come with an exorbitant price tag. Stephanie Osfield investigates the deadly discrepancy in funding in this month's issue of marie claire, on sale now.
On a breezy summer’s morning in December 2014, 25-year-old Jess Pereira woke to find that her lower back felt stiff and sore.
Jess was an active young woman, her mind focused on the European holiday she was planning with her husband, Andrew, and as she eased herself out of bed, she surmised it was nothing more than the legacy of some intensive gym sessions.
The pain, however, didn’t go away. A few weeks later, by which time it was also shooting down her leg, she saw her GP. After an MRI scan, the doctor delivered the chilling words: "You have tumours that could be cancer."
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More tests confirmed the worse. Jess had cancer: a rare, aggressive form of lymphoma to be precise.
"I didn’t break down and sob until I told my husband and family over the phone," recalls Jess. "At 25, I was staring death in the face."
What followed were months of “sheer hell” as Jess faced excruciating pain, radiation therapy, lumbar punctures every 10 days and chemotherapy.
To cap it off, her enforced absence meant she lost her new job as a legal secretary at a top Sydney firm.
Three times her cancer appeared to be responding to treatment only to return, with tumours appearing in her hip, neck, chest, abdomen, arms and legs.
In June 2015, her specialist said she thought they had run out of options.
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"I remember thinking that I wasn’t going to make it to my 26th birthday," says Jess. "But then my specialist contacted me and said she’d done some research and found a newer drug called Crizotinib."
The only catch? It would cost $7400 a month and Jess needed it for at least six months of treatment.
"I felt completely overwhelmed – how would I ever raise that kind of money? I’m quite shy and the prospect of calling on others for money made me feel like a charity case."
Family and friends rallied and raised $23,000, holding morning teas in their workplaces and passing the hat around at clubs; one friend even sold scarves and beanies online. It meant Jess was able to start treatment with the drug in June 2015.
"The improvement was incredible," she recalls. "Within two weeks, the searing pain and joint stiffness began improving. A month after starting the drug, I had a PET scan and there were no tumours in my body. I can’t tell you how incredibly uplifting that was." The charity Rare Cancers Australia then started crowdfunding to raise funds for Jess to continue treatment.
"But that money [will] run out in December and I am terrified that I might have to stop treatment, and maybe I will die," she says, softly.
And here is the cruel paradox. The luck of the draw, if you can call it that. Had Jess’s cancer started in her lungs and not her back, she would have been able to get the very same drug for just $37.70 per month.
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The difference? The government subsidises the drug for some forms of cancer, but not others.
In Australia, when a drug is listed on the Pharmaceutical Benefits Scheme (PBS), the government subsidises the cost by paying the pharmaceutical company a negotiated price, which means the patient has to pay far less. But first a cancer drug has to get on to the PBS, and critics say there are a number of issues with this system. For one, they argue that the approval process moves at a glacial pace and is costing patients their lives; they also want to see the system streamlined.
Secondly, they say drugs on the PBS should be approved for the treatment of a wider range of cancers. Until progress is made, doctors are left facing an ethical dilemma. Specialists question whether to tell patients, who are losing their hair and suffering pain, nausea and extreme fatigue, that there are drugs that might help, but they can cost nearly $8000 every month. “Forty-one per cent of oncologists said they were less likely to mention a cancer drug if it was not subsidised, because the knowledge that the patient could not afford it would be too distressing for [them],” says Professor John Zalcberg, co-chair of Cancer Drugs Alliance and head of the Cancer Research Program at Monash University.
Those patients confronted with the sky-high price tags (set by pharmaceutical companies) of drugs not on the PBS are faced with a terrible choice: go without the drug that may extend their life, or make desperate attempts – such as selling the house – to raise the money.
Read the full story in the January issue of marie claire magazine, on sale now.
*Annual cost of drug
