Monday, March 4, 2013


An essay in the Sacramento Bee by Dr. Michael Wilkes, a professor at U.C. Davis School of Medicine ( posits that pharmaceutical costs are not only going through the roof, but may be rising above the drugs' level of usefulness. He cites a drug used to treat melanoma, the cost of which is $120,000 for four treatments. If the drug succeeds, the patient’s life might be extended a few months. The majority of new cancer drugs cost at least $20,000 for a 12-week course, and often people need multiple courses and multiple drugs.

Of course, Big Pharma contends that drug development is an incredibly costly endeavor without no guarantee of return on investment. For a counter-argument, look up pharmaceutical firms’ even more incredible annual profits. A current fact of life is that healthcare is subject to corporate control, period. If you’re going to wait for that to change, don't hold your breath.

One possible resolution may reside in an old Jack Benny joke. A mugger, the story goes, flashes a gun at Benny and cries, "Your money or your life!" There's a pause. The mugger repeats, "I said, 'Your money or your life!'" Benny says, "I heard you. I'm thinking."

If four melanoma treatments for $120,000 might extend my life for four months, I ought to think: is that worth it? Should my family entertain bankruptcy for extending my side-effect-ridden existence for a short time? I'm finding that an increasing number of patients and their families who face this kind of question are opting for gracefully dying. It takes courage to fight, and it also takes courage to submit. As we become more sophisticated philosophically, life-at-any-cost looks less acceptable, and we become better shoppers.

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