All psyched up, but we now have canceled the Thursday chemo session. It will be rescheduled, but there are a bunch of revisions to be arranged, it turns out.
Yesterday, the nurse at the infusion center with whom Ed has been working, who is named Tara, mentioned that the pill version of the main drug (5FU) is pretty expensive and Ed might want to check what his co-pay would be. That is not an easy thing to be achieved from this side of the equation, so Tara also worked on it. This morning, Tara called to say that she'd sent the prescription to the pharmacy. Ten or fifteen minutes later, the pharmacy called to talk to Ed about the cost of the prescription, at Tara's request. It turns out that Xeloda, the drug in question, costs $3,000 for each two-week round. Ed's co-payment is $25. This is good insurance.
But the thing is, the reason he is choosing to take Xeloda, rather than 5FU (which is given by infusion), is because then we will not have to deal with a permanent line placement and the accompanying requirement for a weekly sterile dressing change and someone to remove the line on the second day after the treatment is started. There is no evidence that this drug is any different in its effect on the cancer than the 5FU. So, it's $3K every 2 or 3 weeks for our convenience. This didn't feel good. Neither of us thinks that's a good use of health care resources, although Tara did congratulate Ed on his terrific co-pay level. But she also said she wished everyone was as concerned about costs.
But for all we know, the 5FU costs just as much? Well, nope, about $30-$40, although there are some associated costs for the permanent line and the portable pump, but there aren't any apparent additional labor costs because in any case the patient is getting a 2-hour infusion of 2 other drugs every two weeks, so the 5FU is started at the same time and then continued on the patient's own time.
Thus, shifting to the 5FU, the permanent line placement, and the pump requires new prescriptions and arrangements. That will happen tomorrow and then they'll reschedule the actual treatment session. It's a little weird to be involved in health policy while dealing with actual treatment.
