Breast Cancer and the Multibillion-dollar Prescription Drug Trade

PJ Hamel Health Guide
  • “Multibillion-dollar prescription drug trade”–chilling words, aren’t they? Think of many billions of dollars–that’s billions. And “prescription drug”–what we take only when we’re truly ill and need medical help. And “trade”–business. That’s the worldwide pharmaceutical industry, a business necessarily built on human illness and misery. And the sicker we get, the more the profits mount.

    Attention, those of you who work (or have stock in) in the drug industry: before you get your hackles up, understand that I’m not out to trash Genentech, Pfizer, Merck, AstraZeneca, or any part of the “Big Pharma” industry. I’m sure they have their issues, like all businesses. Questionable decisions made as the result of office politics. A few people at the top making ridiculous amounts of money, while the workers at the bottom struggle to put $3/gallon gas in the old Buick. Corners cut here and there, often unbeknownst to anyone save the lab tech hurrying through a procedure in order to get to the cafeteria before the lunchtime rush. But bottom line, Big Pharma is providing us with a vital product: the drugs that save our lives.
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    However, speaking of bottom line, I’ve been struck recently by one example of drug cost and company profit that keeps coming up in my research: the price of Avastin, a lung- and colon-cancer drug, as well as an off-label treatment for metastatic or triple-negative breast cancer. And the profits reaped by Genentech, America’s largest biotechnology firm.

    First, let’s talk drug cost. The pricetag for Avastin varies from cancer to cancer. Unfortunately, breast cancer patients pay the highest price: about $100,000 a year. Insurance may cover all of it, IF you have a very generous plan, and the insurance company agrees to pay for an “experimental” breast cancer drug (not FDA-approved, despite clinical trials proving its value). Or insurance may cover part of it, with the patient responsible for co-pays–which could run upwards of $10,000-$20,000 a year.

    Without insurance… well, you’d better be rich. Responding to public outcry about its cost to patients, Genentech has placed a price cap on Avastin of $55,000/year if your household income is less than $75,000/year. Do the math: you make less than $75,000/year, and you’d have to pay up to $55,000/year for your cancer drugs? HA. If you make $60,000/year, you don’t bring home even close to $55,000, after taxes. A $55,000 cap is like washing a single dirty fork after a banquet for 200 people and saying “Look, I’m cleaning up!” Sounds good, but it doesn’t add up.

    And I’m STILL not trashing Genentech. They’ve put a price cap in place, ineffective though it seems at first glance. They’ve instituted an Avastin Patient Assistance Program (which, unfortunately, doesn’t cover breast cancer patients). Genentech also donates about $50 million a year to charities that help patients cover co-pays on any cancer drugs, not just those made by Genentech. For a multibillion-dollar company, they seem to be trying; I don’t believe they’re laughing all the way to the bank.

  • On the other hand, according to a Jan. 14 Associated Press story, Genentech’s 2007 profit of $2.77 billion was up 31% over 2006. And annual revenue was $11.72 billion, up 26 percent from a year earlier. Though Avastin sales have recently slowed, those are still huge figures.
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    Is there no middle ground here? Someplace where shareholders’ stock price and patients’ drug cost can comfortably co-exist?

    Illness, death, and profit–strange bedfellows, indeed.
Published On: January 20, 2008