I am thinking that this can be a post title that we'll be able to use again. In this waiting space, you get a little health policy and, at the end, what happens next. Otherwise, nothing is happening at the moment.
After the discussion about the pill/Xeloda and it's terrific price, we did a little research on the costs of all this. One of the side amusements (so to speak) of listening to the Republicans talk about medical care, the market place and being a good consumer, and of actual needing medical care in the market place and trying to be a good consumer is the lack of fit. Everybody always complains about the GOP position that when you are sick you have neither the time nor the energy nor the focus to be a good consumer. But actually, we do, and you can't do it. Nobody knows what anything costs, and that is partly because nothing costs just one price. It all depends upon what your insurance company has negotiated with the drug companies, the hospitals, the doctors, etc., and what your insurance company has negotiated with you.
So, Tara reasonably cannot be expected to know any more about the cost of Xeloda than that it's expensive and you better check your co-pay. In a more recent conversation with Tara, she reported that one of the other drugs (Avastin) costs $6,800 per dose (you get one every other week). Our view is that she was given that number to try to put our concerns about costs into perspective. And it did, since it led to a search for how much this chemo regimen as a whole was costing.
Fortunately some good docs had put those numbers together (2007 data) and it turns out that 12 weeks of the Xeloda pills plus the drug (Oxaliplatin) runs about $50,000 (and, with the Avastin, about $90,000 total); the alternative route with 5FU, Leucovorin, and Oxaliplatin (all of which is infused) runs to $28,000 with the additional Avastin providing a total of $60,000. And, you have to think that they are recommending that you keep up this treatment as long as you are alive. So, we're talking big money here. (Note that there are different ways to figure out the drug costs and this particular analysis used Average Wholesale Cost, so this is just what it would cost on average, not what it would cost your insurance company or you or Medicare or Medicaid, etc.)
Even though I know a lot about this kind of stuff because I have kept up reading about it even after I left bioethics, I was startled by these costs, just because they don't involve any hospitalization or other fancy interventionist technologies. And that's another reason you're not going to be a good consumer, because you are not going to know anything about these costs until you get a bill. And if your insurance bill is anything like a Medicare/Blue Cross Anthem bill, you are still not going to know much because the bills are very difficult to decipher in my experience.
So, the Friday appointment was canceled while Tara and then Neva tried to get Vanessa to coordinate appointments to get the chest port placed, which is a 'minor surgical procedure' provided by 'an interventional radiologist'...okay, but I've actually never heard the phrase 'interventional radiologist,' so my vocabulary has been broadened. We expect to hear from Vanessa on Monday, but we expected to hear from Neva on Friday. So, we wait, and I, at least, don't mind too much.
