Current Issues in Healthcare: The cost of a life

$95,000.

Image from Evan-Amos via Wikimedia Commons.

Image from Evan-Amos via Wikimedia Commons.

 

$72.

 

Both of these are figures I came across recently that are related to the cost of someone’s life.  The first is an estimate of the added costs of prolonging a lung cancer patient’s life with a diagnostic test followed by crizotinib treatment (1,2): the added cost of the test plus first-line crizotinib over standard care is $95,000.  The projection is that crizotinib will prolong survival for 7.7 months, so when $95,000 is converted to quality-adjusted life years (QALY), the cost is $250,000 per QALY gained. The conclusion of the study authors was that this is not a cost-effective use of resources, at least from the view of Canadian healthcare.

 

With that kind of an assessment, a cynic may say that this analysis says that, in general, someone’s life is not worth $250,000 per year in health care-related expenses.  In a situation with limited resources, it’s certainly a challenging discussion to have.

 

However, while no one will argue against the notion that healthcare costs should be kept under control, perhaps what’s most shocking is not the ceiling for what someone’s life could cost but rather the floor.

 

What’s the floor? Love146 reports that one child in their survivor care program was sold to a brothel for a mere $72.  Many other places and organizations report minors being sold for only a few hundred dollars.  The distance between these ‘prices’ and healthcare expenditure caps of tens of thousands of dollars is almost comical if it weren’t so tragic.

 

While we may be frustrated, even angered, about limits on what government and private insurance agencies deem to be cost-effective to keep someone alive, we should even more so be outraged at how little a trafficker has to pay to ‘own’ someone who shouldn’t be theirs in the first place.  And perhaps the conversation about what’s cost-effective should instead be around how much we are willing to spend to help someone recover from something they never should have experienced in the first place.

 

Steve Mason, Ph.D., is the Senior Editor of Biological Sciences of Cancer InCytes Magazine. The opinions expressed in this article are those of the author and do not necessarily reflect any company or organization.

 

References

1. Kelly Rj, Hillner BE, Smith TJ. J Clin Oncol. 2014;ePub ahead of print Feb 24.

2. Djalalov S, Beca J, Hoch JS, et al: Cost-effectiveness of EML4-ALK fusion testing and first-line crizotinib treatment for patients with advanced ALK-positive non–small-cell lung cancer. J Clin Oncol. 2014;ePub ahead of print Feb 24.

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