HealthBlog

Thoughts, comments, news, and reflections about healthcare IT from Microsoft's worldwide health senior director Bill Crounse, MD, on how information technology can improve healthcare delivery and services around the world.

Health Reform and the $75,000 Cancer Vaccine

Health Reform and the $75,000 Cancer Vaccine

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Bill Crounse 2007 03 I arrived back in Seattle from my business trip to Australia just in time to catch the headlines in Sunday’s Seattle Times, “Seattle biotech firm on verge of groundbreaking cancer vaccine”.  The article told the story of a local firm, Dendreon, and its new vaccine to treat prostate cancer, Provenge.  If, according to the article, the Food and Drug Administration approves the vaccine it will be one of the biggest breakthroughs in Seattle’s biotech industry in a decade.  A researcher is quoted as saying this may the the first in a long line of such vaccines to be approved over the next 8 to 10 years.

imageThe vaccine isn’t designed to prevent prostate cancer.  It is used as a treatment to slow down the cancer and prevent it from metastasizing.  The article states that Dendreon has already sunk $750 million into the vaccine’s development.  If approved (UPDATE:  The vaccine received FDA approval April 29th, 2010), treatment with the vaccine is expected to cost $50,000 to $75,000.  Analysts say the vaccine may be appropriate for up to 100,000 men each year who develop the advanced type of prostate cancer the vaccine is designed to treat.

image Having just come from Australia, which like the UK has a public health system offering care for everyone, and having been grilled by the press there on how the Australian health system compares to the newly enacted health reforms in America, I noted with some irony not only the headlines about the new vaccine but also with pundits everywhere who question whether America’s health reform is focused enough on controlling costs.  Can we, or any society, afford such treatments now and especially in the future with our growing deficits, aging population and increasing incidence of chronic diseases?

I won’t attempt to answer that question here.  $75,000 may actually be a bargain compared to some of the costs currently associated with other cancer treatments.  I know of a family friend who is being treated for a particular type of blood cancer to the tune of $50,000 a month, and this has been going on for more than three years.  With everyone in America soon to be insured and everyone with coverage that has no upper limits nor any possibility of being refused for treatment, how can this possibly pencil out with insurance premiums that anyone besides multi-millionaires can afford?  I don’t think it does.

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Today, I also came across an interesting article about a Senate panel examining the role of health IT as the population ages.  It suggests that home monitoring and other tele-health technologies might save up to $200 billion over ten years if used for people suffering from just four of the most common chronic conditions.  But before that can happen, we must have aligned incentives so care providers will use such technology.  We must also revise outdated regulations and make sure that broadband connectivity is affordable and available to those who need it.

Maybe if some of that happens, we can afford $75,000 vaccines!

Bill Crounse, MD  Senior Director, Worldwide Health   Microsoft

  • Maybe the government should take over R&D too.  Then, we would never have worry about the choice of paying $75000.  It simply wouldn't exist.

  • @Victor - Who would trust people working for the government who have no ambition and whom the government will not fire and when government employees have more health issues than employees in the private sector. Government is lazy and slow. The Dendreon vaccine would have probably taken twice the amount of people and 3 times the amount of time to develop if the government was creating and probably half as effective.

  • That's a pretty broad brush, Victor.  I can think of several areas where the government is much more efficient than private enterprise.  Start with Medicare with roughly 5% overhead versus private insurance with 20 to 30%.  Frankly, if I'm going to pay for healthcare with my taxes, I want the most efficient and cost effective deal going.  The same goes for the rest of the public infrastructure - but we seem stuck is some sort of government give away for things that the government could do a lot cheaper, like roads for example. Sometimes the free market economy can perform better, other times it needs a kick in the ass.

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