The first slap

The first slap
This photo was taken the day after I was diagnosed, and it is my first bitch slap at cancer. I'm the one with the icepack symbolically placed on my boob. My teammates changed our team's uniform to pink at the last minute, and I came off the soccer field that night with one goal and a whole lot of love. Several of these women are my close friends, but they are all warriors, and they all helped me set the tone for this fight.

Monday, May 19, 2014

Major Medical

What would you do if you didn't (or don't!) have health insurance and all of a sudden you became "sick" or injured, your ailments falling into that category of "major medical?" And note that it does happen all of a sudden. In fact, all at once, you can become "sick" even when you feel "normal" and "healthy." That's how it happened for me last November when I was diagnosed. It's bat-shit scary, and that's before taking into account the potential financial hit.

I've taken a while to write about this only because I've had other things to say and simply haven't had the energy to get to it until now. But earlier this winter or spring, Craig was looking at statements and bills, and noted the cost of just one of my chemotherapy infusions from chemo course #1 (prior to surgery). This was when I received Taxol on a weekly basis and a cocktail of Taxol, Herceptin, and Perjeta every three weeks. The cost for one of these cocktails? About $50,000. We've all heard about the exorbitant costs of healthcare in the U.S., but seriously--$50,000 for one episode of chemo?

So what's going on here? That's actually a serious question, because I really don't know. I imagine it's partially the super-high price tag slapped onto new and innovative drugs like Perjeta (which, along with Herceptin, is made by Genentech), which has only been on the market for a year or two. But an article in Pharmacy Times lists the cost at just under $5,000 per dose (http://www.pharmacytimes.com/publications/health-system-edition/2012/August2012/Pertuzumab--Perjeta). And according to a Wikipedia article, Herceptin can cost about $70,000 for a full course of treatment (http://en.wikipedia.org/wiki/Trastuzumab). Even if we included Taxol, these numbers don't add up to $50,000 for one infusion of Taxol, Herceptin, and Perjeta. Sure, I would also get Benadryl, Zofran, and saline, but still...

According to an article in today's New York Times, the primary source of healthcare costs is not healthcare workers or physician's bills. Rather, it's executive salaries in the medical business world: http://www.nytimes.com/2014/05/18/sunday-review/doctors-salaries-are-not-the-big-cost.html?smid=fb-nytimes&WT.z_sma=OP_MTE_20140519&bicmp=AD&bicmlukp=WT.mc_id&bicmst=1388552400000&bicmet=1420088400000&_r=2. This includes CEOs of health insurance firms and hospital administrators, who make much more money than general physicians and nurses do. I'm thinking oncologists may make more than general physicians, but still--this article does an excellent job of pointing out where our "major medical" expenses are coming from, at least in part.

I would really love to know what those of you who work in the healthcare and biomedical industries know and think about all of this. Although I have no answers, I do know this: I am extremely fortunate not only to live in a place with quality healthcare, but also to be fully insured. I honestly cannot imagine what this whole experience would be like if I did not have that kind of security. And thus, I find it very very difficult to imagine why so many people would want to keep so many people from securing the same peace of mind. Obamacare ain't perfect, but neither are our bodies.

The Average Wholesale Price of pertuzumab (Perjeta) is $4890 per 420-mg vial. - See more at: http://www.pharmacytimes.com/publications/health-system-edition/2012/August2012/Pertuzumab--Perjeta#sthash.8451ACmy.dpuf
The Average Wholesale Price of pertuzumab (Perjeta) is $4890 per 420-mg vial. - See more at: http://www.pharmacytimes.com/publications/health-system-edition/2012/August2012/Pertuzumab--Perjeta#sthash.8451ACmy.dpuf

1 comment:

  1. As you know, I'm not in the healthcare or biomedical fields. But this is a very real concern - the cost of treatment for illnesses like cancer. It's definitely a fear of mine: being without health insurance. We have been in such situations, particularly after Julian was born. However, paying out of pocket for health insurance for one's family in the early-to-mid 1990s wasn't terribly steep; I think we paid $120/month for a year or so before Brian's student health plan kicked in (this was when he started at Columbia), and we all got coverage through him. Now, forget paying out of pocket! The sticker price is sky high.

    There are foundations out there that are addressing this gap, though, or - at least - trying to. One is the Catherine H. Tuck Foundation, https://catherinefund.org/Home.html . It also points to various other organizations that provide financial and other support for women with breast cancer: https://catherinefund.org/Resources.html .

    And I heartily agree - the Affordable Healthcare Act may not perfect, but it's definitely serving an urgent need.

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