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FDA Rationing of Medical Care Based on Cost To Medicare? https://gladerebooted.net/viewtopic.php?f=8&t=5029 |
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Author: | Vindicarre [ Tue Dec 21, 2010 6:48 pm ] |
Post subject: | FDA Rationing of Medical Care Based on Cost To Medicare? |
IBD Thinks So Spoiler: So do these folks Spoiler: Yup. They pulled it. |
Author: | Aizle [ Tue Dec 21, 2010 7:53 pm ] |
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My understanding is that Avastin had no effect on the survival rates of patients, so it was basically non-effective. |
Author: | Vindicarre [ Tue Dec 21, 2010 8:15 pm ] |
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The clinical trials I've seen disagree with your understanding; so do the folks at the EMA and the European Committee for Medicinal Products for Human Use. Why would they only remove the approval for metastatic breast cancer and not for lung, brain, kidney and colon cancers? Could it be because many more people take the drug fro breast cancer than the others, and that's too expensive? |
Author: | Lydiaa [ Tue Dec 21, 2010 8:19 pm ] |
Post subject: | Re: FDA Rationing of Medical Care Based on Cost To Medicare? |
I Can't comment on the actual survival rate after using this medicine, but I can tell you Avastin is amazing in reducing blood flow and killing off capillaries to the areas administered with out too many untoward side effects. I myself was on it for about a year (not for cancer but for something else). It slows down growth (sometimes stopping and reversing it altogether), which in some agressive cases means you have longer to wait for a donor. I wouldnt say that Medicare/medicaid is rationing health care, but Avastin is really more a 'premium' drug then one thats necessary for life. In the case of breast cancer, removing the best is the better cure (even if it's metastasizing) then using Avastin. |
Author: | Vindicarre [ Tue Dec 21, 2010 8:21 pm ] |
Post subject: | Re: FDA Rationing of Medical Care Based on Cost To Medicare? |
Lydiaa wrote: I wouldnt say that Medicare/medicaid is rationing health care, but Avastin is really more a 'premium' drug then one thats necessary for life. Heh, ummm, that's pretty much the whole basis of rationing care. |
Author: | Stathol [ Tue Dec 21, 2010 8:40 pm ] |
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I don't think that's accurate. This blog goes into a lot more detail. As far as I can tell, none of the studies have ever shown any affect on OS (overall survival) rates with respect to metastatic breast cancer. What was demonstrated in E2100 was a ~5.5 month increase in PFS (progression-free survival). Since then, there have been two new studies specific to metastatic breast cancer: AVADO and RIBBON1. Both studies showed only about a 1 month increase in PFS. They also both demonstrated some adverse affect on OS. The ODAC's stance seems to have been that E2100 was sufficient grounds for fast-tracking Avastin for metastatic breast cancer, but that it was conditional on these two follow-up trials confirming the effect on PFS and a lack of negative effect on OS. Since the results of AVADO and RIBBON1 more or less subverted the results of E2100, ODAC reversed their decision to fast-track it for this purpose. The FDA itself, as far as I know, hasn't yet made a ruling. I have to run, but I'll bring this up with my sister. She's a radiation oncologist, not chemo, but she works with breast cancer a lot, so she have some insight on this. |
Author: | Colphax [ Tue Dec 21, 2010 8:43 pm ] |
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Rationing based upon cost is rampant in healthcare in general, not just the government. Look at your private health insurance's drug coverage. Chances are your drug coverage has a formulary that lists which drugs your insurance will fully or partially cover. If a drug is not on that formulary list, you must pay full price for the drug. Private insurance companies also do other stuff, such as classify expensive but life-saving procedures as "experimental" so that they can deny coverage. The sad truth is that enough patients accept or don't fight the denials that the insurance companies so that the ones that do and win multi-million dollar settlements are counted as acceptable risk/cost of doing business. Now don't get me wrong, I'm not a fan of healthcare reform as it turned out. There's not enough free market in it for my taste. But I don't see much of an issue for the government to be doing something the private industry itself already does. |
Author: | Xequecal [ Tue Dec 21, 2010 9:12 pm ] |
Post subject: | Re: FDA Rationing of Medical Care Based on Cost To Medicare? |
"Experimental" treatments are actually a huge problem because a lot of health care research is not driven by profit. So much charity money is thrown at health care research that the treatments being discovered have long outstripped the average person's ability to pay for them. |
Author: | Kaffis Mark V [ Tue Dec 21, 2010 11:59 pm ] |
Post subject: | Re: FDA Rationing of Medical Care Based on Cost To Medicare? |
Xequecal wrote: "Experimental" treatments are actually a huge problem because a lot of health care research is not driven by profit. So much charity money is thrown at health care research that the treatments being discovered have long outstripped the average person's ability to pay for them. Definitely this. In addition, insurance is so prevalent that the notion that people would actually have to afford something isn't even a consideration when researching, even if the research weren't charity driven. It's that extra step of removal. And rationing? In a government health care system? Color me shocked! I think that's a bright pink, by the way. |
Author: | Taskiss [ Wed Dec 22, 2010 6:19 am ] |
Post subject: | Re: FDA Rationing of Medical Care Based on Cost To Medicare? |
Kaffis Mark V wrote: I think that's a bright pink, by the way. That they can cure. |
Author: | Talya [ Wed Dec 22, 2010 10:09 am ] |
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Everything is rationed, even in a capitalist system. The only differences are criteria for how it is rationed. |
Author: | Aizle [ Wed Dec 22, 2010 10:38 am ] |
Post subject: | Re: |
Talya wrote: Everything is rationed, even in a capitalist system. The only differences are criteria for how it is rationed. Yup. And I personally don't feel that wealth should be the yardstick used to determine getting healthcare. |
Author: | Elmarnieh [ Wed Dec 22, 2010 12:33 pm ] |
Post subject: | Re: Re: |
Aizle wrote: Talya wrote: Everything is rationed, even in a capitalist system. The only differences are criteria for how it is rationed. Yup. And I personally don't feel that wealth should be the yardstick used to determine getting healthcare. And since perfect altruism doesn't exist - what metric should be used which wouldn't infringe on either the rights of property or contract? |
Author: | shuyung [ Wed Dec 22, 2010 12:35 pm ] |
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Aizle wrote: And I personally don't feel that wealth should be the yardstick used to determine getting healthcare. Why not? What do you have against wealth that makes random chance look so attractive? Do you think you would stand a better shot at obtaining treatment in a lottery system? Are you saying that your confidence in your ability to provide for yourself is so low you'd rather take odds that make a 200-1 shot at the track look like a lock? |
Author: | Aizle [ Wed Dec 22, 2010 1:14 pm ] |
Post subject: | Re: |
shuyung wrote: Aizle wrote: And I personally don't feel that wealth should be the yardstick used to determine getting healthcare. Why not? What do you have against wealth that makes random chance look so attractive? Do you think you would stand a better shot at obtaining treatment in a lottery system? Are you saying that your confidence in your ability to provide for yourself is so low you'd rather take odds that make a 200-1 shot at the track look like a lock? Because I feel that wealth is a terrible marker for "worth". Who said I was suggesting random chance? Nope, I wouldn't have a better shot in a lottery system. I have plenty of confidence in my ability to provide for myself, but that's not relevant IMHO. As for Elmo's question, I don't have a good answer to that. However, I feel that wealth unfairly places too much advantage in a small number of people for services that they don't always need and sometimes don't deserve over others who are in greater need. |
Author: | Vindicarre [ Wed Dec 22, 2010 1:25 pm ] |
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Then you should be quite disappointed, Aizle, that by fiat, a group of unelected officials can deny everyone but the wealthy treatment options. |
Author: | shuyung [ Wed Dec 22, 2010 1:29 pm ] |
Post subject: | Re: Re: |
Aizle wrote: Because I feel that wealth is a terrible marker for "worth". Who said I was suggesting random chance? Nope, I wouldn't have a better shot in a lottery system. I have plenty of confidence in my ability to provide for myself, but that's not relevant IMHO. Well, it goes like this. If there exists a resource for which demand exceeds supply, and if an individual cannot obtain this thing via an exchange of resources (money for treatment, in this case), then the only way (ignoring theft of some sort) to obtain this thing is by being gifted it. Somebody in control of it has to give it to you. With a large enough demand, and a small enough supply, assuming that equal chance of obtaining this thing is desired (maybe it's not, maybe we like favoritism) then the only way to do that is by basically drawing names from a hat. As for markers for worth, it somewhat boils down to how you define worth, doesn't it? What makes one person worth more than another? Do you even accept that one person can be worth more than another? |
Author: | Rorinthas [ Wed Dec 22, 2010 1:42 pm ] |
Post subject: | FDA Rationing of Medical Care Based on Cost To Medicare? |
Aizle wrote: shuyung wrote: Aizle wrote: And I personally don't feel that wealth should be the yardstick used to determine getting healthcare. Why not? What do you have against wealth that makes random chance look so attractive? Do you think you would stand a better shot at obtaining treatment in a lottery system? Are you saying that your confidence in your ability to provide for yourself is so low you'd rather take odds that make a 200-1 shot at the track look like a lock? Because I feel that wealth is a terrible marker for "worth". Who said I was suggesting random chance? Nope, I wouldn't have a better shot in a lottery system. I have plenty of confidence in my ability to provide for myself, but that's not relevant IMHO. As for Elmo's question, I don't have a good answer to that. However, I feel that wealth unfairly places too much advantage in a small number of people for services that they don't always need and sometimes don't deserve over others who are in greater need. Trust me it's not the rich who are clogging the ER wether they need to be here or not. It's the subsidized who bring in their 5 children to the ER because one of them had the sniffles. |
Author: | Aizle [ Wed Dec 22, 2010 1:43 pm ] |
Post subject: | Re: Re: |
shuyung wrote: As for markers for worth, it somewhat boils down to how you define worth, doesn't it? What makes one person worth more than another? Do you even accept that one person can be worth more than another? This is the real question. It's a hard one to answer. Probably even impossible. Using biblical references, Jesus was amazingly poor yet I suspect most folks that post here would say he was worth quite a lot. I absolutely believe that some people are worth more than others. But when laws are concerned, they shouldn't be. Equal protection under the law and all that. It's really a tricky situation and I honestly don't have a good suggestion for it. I guess I would start by looking at other countries around the world to see how they determine priority and to what extent it's been successful for them or not. |
Author: | Elmarnieh [ Wed Dec 22, 2010 1:51 pm ] |
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I think we are all free to think that another doesn't deserve something but we aren't free to use force to prevent them from making agreements with others - however that is what government intervention does. Its also fine to say "I don't like this, we should look at alternatives" but until one has a working alternative that does not necessarily violate rights - we keep the current system and work to sure up any perceived shortcomings. |
Author: | Ienan [ Wed Dec 22, 2010 2:45 pm ] |
Post subject: | Re: Re: |
Aizle wrote: shuyung wrote: As for markers for worth, it somewhat boils down to how you define worth, doesn't it? What makes one person worth more than another? Do you even accept that one person can be worth more than another? This is the real question. It's a hard one to answer. Probably even impossible. Using biblical references, Jesus was amazingly poor yet I suspect most folks that post here would say he was worth quite a lot. I absolutely believe that some people are worth more than others. But when laws are concerned, they shouldn't be. Equal protection under the law and all that. It's really a tricky situation and I honestly don't have a good suggestion for it. I guess I would start by looking at other countries around the world to see how they determine priority and to what extent it's been successful for them or not. I rather wealth being the factor than an arbitrary bureaucrat making the decision. At least wealth is generally a good indicator of someone who worked hard and contributed more to society. So if it has to be rationed, which I don't think is necessarily a given under a free market capitalist system, I rather the contributors to society reap the benefits, rather than picking some arbitrary means, such as a compassion vote or someone who might live longer than another based on statistical analysis. |
Author: | Screeling [ Wed Dec 22, 2010 2:55 pm ] |
Post subject: | Re: Re: |
Aizle wrote: shuyung wrote: As for markers for worth, it somewhat boils down to how you define worth, doesn't it? What makes one person worth more than another? Do you even accept that one person can be worth more than another? This is the real question. It's a hard one to answer. Probably even impossible. Using biblical references, Jesus was amazingly poor yet I suspect most folks that post here would say he was worth quite a lot. I absolutely believe that some people are worth more than others. But when laws are concerned, they shouldn't be. Equal protection under the law and all that. It's really a tricky situation and I honestly don't have a good suggestion for it. I guess I would start by looking at other countries around the world to see how they determine priority and to what extent it's been successful for them or not. So while you don't come up with an answer, you support a solution that will make it worse for people who can pay because "fairness" assuages your conscience that you're not neglecting the poor? |
Author: | Aizle [ Wed Dec 22, 2010 3:04 pm ] |
Post subject: | Re: Re: |
Ienan wrote: At least wealth is generally a good indicator of someone who worked hard and contributed more to society. I disagree completely on this statement. |
Author: | Ienan [ Wed Dec 22, 2010 4:11 pm ] |
Post subject: | Re: Re: |
Aizle wrote: Ienan wrote: At least wealth is generally a good indicator of someone who worked hard and contributed more to society. I disagree completely on this statement. Based on...? Generally, the more you are compensated, the more valuable you are in a free market society if we assume compensation = labor. There are certainly other factors and exceptions to the rule, but that's why private charities exist. Of course, since our system largely isn't free market anymore (by the way this is purposeful exaggeration if anyone didn't get it), I would actually happen to agree with you. |
Author: | Aizle [ Wed Dec 22, 2010 4:36 pm ] |
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Based on common sense. There are plenty of wealthy people who inherited their wealth, and haven't contributed anything worthwhile to society at all. There are also plenty of people for whom money is not a powerful motivator who have contributed huge amounts to society. |
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