Jul 13, 2009

My Life is Worth What?

Remember that nasty little word - rationing - that keeps rearing its ugly head? Well, here is a bit more food for thought. The decision to use expensive cancer therapies that typically produce only a relatively short extension of survival is a serious ethical dilemma in the US being debated by the oncology community published, June 29 in the Journal of the National Cancer Institute.

The authors show cost-benefit relationships for several cancer drugs. They ask, "Is an additional 1.7 months a benefit regardless of costs and side effects?" (They don't answer a benefit to whom.)

According to the article, one drug was found to extend life by 1.2 months and cost an average of $80,000, which translates into an expenditure of $800,000 to prolong the life of one patient by 1 year. They describe how much it might cost to extend the lives of 550,000 Americans who die of cancer annually, by 1 year.

They recommend that studies to detect a survival advantage of two months or less should test only interventions that can be marketed at a cost of less than $20,000 for a course of treatment.

Every life is of infinite value, the authors say, but spiraling costs of cancer care makes this dilemma inescapable. I thought this was against the Hippocratic oath, so went to find out exactly what the oath says. Seems there are multiple versions and all physicians do not even take the oath. They believe it is outdated and less than relevant these days.