34 We are dedicated to improving the health and How Can We Cut the Cost of Medical Care? safety of adults and children by using research to develop Everyone agrees that health insurance is too Our own research on cancer drugs found that expensive and prescription drugs cost much too many that were recently approved based on their more effective treatments and much – some cost more than patients’ annual success at shrinking tumors provided zero benefit income! The amount Americans spend on to the average patient in terms of living longer or policies. The Cancer prescription drugs has nearly doubled since the having a better quality of life. Since cancer drugs Prevention and Treatment 1990s, and today the most expensive drugs cost so often cause nausea, vomiting, exhaustion, and $500,000 or more per year. other debilitating side effects, it is unconscionable Fund is our major program. that these drugs are being approved without clear What’s the solution? evidence that they work – or which patients have at least some chance of benefitting even if most This article isn’t about Medicare for All, Medicaid don’t. for All, or other major legislation, all of which face enormous political and corporate opposition. Instead, this article focuses on the issues that would be easier to fix in the near term. How to Spend Less on Drugs and Medical Tests Too many patients are being priced out of the Our Cancer Prevention and medical treatment that they need – or think they Treatment Fund helps adults need. As prices have risen, companies have broken one record after another, so that it seems there is and children reduce their risk no limit on what they will charge. For example, Spinraza, a treatment (not a cure) for a rare of getting cancer and helps disease called spinal muscular atrophy, is priced at everyone get the best possible $750,000 per patient for the first year, and several Does Competition Matter? hundred thousand dollars per patient in treatment. subsequent years. Even if insurance will cover the Instead of lowering the cost of medical care by cost for some patients, we all pay for these and requiring solid evidence that every drug and device other exorbitant drugs because these prices that is approved has benefits that outweigh the increase the insurance premiums that everyone risks for most patients, the FDA has focused on the pays – even those of us who don’t need such possible benefits of competition between medical expensive treatments. products. The agency claims that getting more Cancer Helpline: drugs on the market more quickly will lower prices. [email protected] But an even bigger problem is the cost of treatments that aren’t proven to work or aren’t needed. Physicians from Mayo Clinic and Stanford FDA is proud of their current efforts to get generic recently published an article in a prestigious drugs on the market more quickly. We support Websites: medical journal stating that many of the billions of those efforts, but unfortunately, generic drugs often cost almost as much as the brand name www.center4research.org dollars spent on diagnostic screening tests such as MRIs and CT scans, are not saving lives. Instead, drugs. And those prices are increasing. www.stopcancerfund.org they are exposing patients to unnecessary radiation, anxiety, and heavy metals (see our For example, the price of digoxin, a commonly article on page 3). In fact, Americans don’t live as prescribed heart medication, increased by 2,800% long as residents of 25 other countries, despite in a single year. The price of 315 generic drugs spending the most per capita on health care. went up by 100% or more in a recent year, causing financial difficulty for many patients. Continued on Page 6 Board of Directors Brandel France del Bravo, MPH Consultant Sarah Deutsch, JD Counsel, Mayer Brown Daniel M. Fox, PhD President Emeritus, Milbank Memorial Fund Ben Gitterman, MD Associate Clinical Professor Pediatrics and Public Health George Washington University Mary G. Hager, MA Journalist (retired) Nancy Hardt, MD Retired Professor and Associate Dean University of Florida College of Medicine Judith L. Harris, JD Reed Smith Alan Mendelson, LLD Axion Venture Partners Omega Logan Silva, MD FDA put breast implant safety in the spotlight at a FDA announced in April that companies must Former President, American stop using surgical mesh for women with pelvic Medical Women’s Association public meeting in March and by making an organ prolapse. It took decades for the FDA to announcement in May. NCHR President Dr. Diana Duchy Trachtenberg Zuckerman told The New York Times, NBC admit that the surgery is just as effective (and Former Councilmember News, Fox News, The Daily Mail, and other safer) when done without mesh. NCHR explains Montgomery County, MD media that women with certain types of family to The Wall Street Journal and Drugwatch medical histories might be more likely to be that mesh was not studied in clinical trials for any Susanne Wilke, PhD, MBA seriously harmed by breast implants. After the medical purposes before it was put in the bodies Venture Capitalist of men and women for incontinence, hernias, meeting, Dr. Zuckerman told AP and The Susan F. Wood, PhD Washington Post about powerful patient breast reconstruction, and other surgeries. The Associate Professor testimonies that convinced some FDA advisors result? Thousands of harmed patients. George Washington University about the potential harm, but that most plastic Diana Zuckerman, PhD surgeons told the FDA that their patients were very President happy with their implants. When FDA announced The International Consortium of Nat’l Center for Health Research in May that they would help warn patients of the Investigative Journalists (ICIJ) has risks, we were quoted in AP, Washington Post, continued reporting stories in “The Implant Fox News, NY Post, and NY Daily News that Files”—a huge online trove of device horror We can’t be bought. the FDA needs to do more to ensure women know stories. We explained to ICIJ why patient the risks before deciding whether to get implants. registries were unlikely to be the great source of safety information that the FDA was claiming. Our Center doesn’t Meanwhile, a Kaiser Health News’ exposé accept funding from revealed that for years, FDA has allowed In an effort to treat more patients, experienced drug companies or companies to summarize rather than individ- surgeons may schedule overlapping operations where ually report how many patients were harmed by device manufacturers, they leave a patient to be "closed" by another health medical devices. Physicians are supposed to so we rely on the professional. A recent study found almost no report problems to help inform other doctors differences in surgical success rates regardless of who generosity of individual and patients which devices are safe and which finishes the surgery. NCHR's Dr. Zuckerman donors. aren’t. NCHR’s President was quoted explaining explained to National Public Radio that while that including information about harmed You can donate there seems to be no greater risk for patients, most patients should be required rather than online at would be unhappy to learn that the surgeon they voluntary, and the data should be made public. stopcancerfund.org. selected is not the one who completed their surgery. Page 2 Thank you to our Another Reason to Avoid MRIs wonderful by Diana Zuckerman, PhD President’s I’ll be honest: I have tried to avoid Magnetic with some types of GBCAs, the next time they get a Resonance Imaging (MRIs) because I am a little bit brain MRI without contrast, there is contrast left Circle Donors: claustrophobic. Being in a very small enclosed over from the previous MRI. In addition, Dianne & Rick Ammons space does not appeal to me, but I All types of researchers have found gadolinium in know that millions of MRI scans are tissues that were removed in surgery or Maryellen Ammons performed every year to help diagnose gadolinium- from autopsies – in the brain, bones, and Crystal Anderson serious health problems and improve other tissues in patients who had received based contrast Holly Bilden-Stehling patients’ treatment outcomes. agents can GBCAs for imaging with contrast. Maureen Bunyan I was advised to undergo an MRI last accumulate in All types of GBCAs can accumulate in your Harry Capossela year to make sure that a tiny spot on a your body; body; however, some types are worse than Christopher Cooper CT scan was nothing serious. So I did others. it, hated every second, and got the however, some Sarah Deutsch good news that the spot was – as types are worse Estate of Amanda Belfiore expected – nothing. So imagine my than others. How Does Gadolinium Affect Benjamin Gitterman surprise to learn in the course of our the Body? Judy Harris & Norm work at the National Center for Health Research Ornstein that many MRIs rely on a contrast agent that is How gadolinium affects the body is largely based on a heavy metal called gadolinium, which unknown and varies from person to person. At this Janet Holt can accumulate in your brain or bones and point, nobody knows how many people are being Catherine Joyce potentially cause serious health problems. affected. Judy Kovler NSF in patients with severely reduced kidney Lisa Lopez & Victor function typically affects patients’ skin first, causing Del Vecchio hardening, discoloration, and swelling. Over time, Alan Mendelson patients’ tendons, muscles, and organs may become David and Connie Povich similarly affected. Pain is common, and NSF can be fatal. Lynn Povich Patricia and Jerry Olson Patients with exposure to gadolinium that have well Andrew Rothenberg functioning kidneys sometimes experience similar, Omega Logan Silva though less severe symptoms as NSF patients.