Cancer patients are being denied drugs, even with prescriptions and insurance • Hacker News Board

Re: Cancer patients are being denied drugs, even with prescriptions and insurance

#71

Post by Scoundreller » Sat, Aug 03, 2019, 6:42 PM UTC

cheeky78 wrote: post #46

tasty_freeze wrote: post #36

One entirely maddening thing is that the ACA was labeled as having "death panels" that would decide who lives and dies. That phrase was powerfully effective in making large group of Americans strongly oppose the ACA. Even if they knew nothing else about the ACA, they knew they didn't want death panels. But as this article demonstrates, if we care to use the inflammatory "death panels" label, we already have them. It…

"But as this article demonstrates, if we care to use the inflammatory "death panels" label, we already have them." It's not inflammatory when it's true. When the government runs our healthcare, choices are removed and someone else gets to decide if you should get surgery needed or not...and many times this is life or death. At least now, if a cancer patient gets denied drugs, they can go to another doctor or get a se…

> All of my elderly relatives live in Canada and come over the border for any major surgery. This is mostly because the wait times are sometimes in the years..when they can just get private care in the US and get it done in a matter of weeks.

Unsure of how popular this is. If it were, we'd see a lot more Us insurers offering plans to Canadians, but as far I know, they're non-existent.

Anywho, all this proves is that you can have a public system and a private system a 100km drive away if you have a problem with it.

Re: Cancer patients are being denied drugs, even with prescriptions and insurance

#72

Post by jMyles » Sat, Aug 03, 2019, 6:43 PM UTC

tasty_freeze wrote: post #36

One entirely maddening thing is that the ACA was labeled as having "death panels" that would decide who lives and dies. That phrase was powerfully effective in making large group of Americans strongly oppose the ACA. Even if they knew nothing else about the ACA, they knew they didn't want death panels. But as this article demonstrates, if we care to use the inflammatory "death panels" label, we already have them. It…

> It makes me despondent that we can ever get to a place where our politicians can make rational, informed decisions about complex issues requiring multiple trade-offs.

It is OK if our politicians can't do this; it just means that, as the information age marches forward, we don't need politicians (or at least, that we don't need the state making these sorts of decisions).

Re: Cancer patients are being denied drugs, even with prescriptions and insurance

#73

Post by hestipod » Sat, Aug 03, 2019, 6:43 PM UTC

xvilka wrote: post #13

It would be very funny if the managers or their relatives who promote these policies will meet cancer themselves. Then they will feel the human price of their profits increase.

You are getting backlash because it seems mean to wish suffering on anyway, and never funny, but honestly I have learned this is the only way most people acquire empathy, though personal suffering. Even then a large number still find a way to blame others.

Re: Cancer patients are being denied drugs, even with prescriptions and insurance

#74

Post by EliRivers » Sat, Aug 03, 2019, 6:43 PM UTC

cheeky78 wrote: post #46

tasty_freeze wrote: post #36

One entirely maddening thing is that the ACA was labeled as having "death panels" that would decide who lives and dies. That phrase was powerfully effective in making large group of Americans strongly oppose the ACA. Even if they knew nothing else about the ACA, they knew they didn't want death panels. But as this article demonstrates, if we care to use the inflammatory "death panels" label, we already have them. It…

"But as this article demonstrates, if we care to use the inflammatory "death panels" label, we already have them." It's not inflammatory when it's true. When the government runs our healthcare, choices are removed and someone else gets to decide if you should get surgery needed or not...and many times this is life or death. At least now, if a cancer patient gets denied drugs, they can go to another doctor or get a se…

I live in a country with public healthcare and getting a second opinion from another doctor is by no means unusual.

Re: Cancer patients are being denied drugs, even with prescriptions and insurance

#75

Post by Scoundreller » Sat, Aug 03, 2019, 6:48 PM UTC

roberte3 wrote: post #56

I have a really rare cancer, and it didn't get detected until I hit stage IV and it started shattering my bones. Thankfully I lived 2 miles from a cancer research hospital that actually has a specialist in this type of organ cancer. My current treatment regime is based on a research paper. My insurance initially denied me treatment based on "an expert in the field" and stupidly listed the doctors name. I looked her u…

Anecdotes are great and all, but we still don't know if the textbook treatment would have worked better or not.

Certainly those that failed with the exotic treatment plans won't be around to complain about it.

Re: Cancer patients are being denied drugs, even with prescriptions and insurance

#76

Post by Scoundreller » Sat, Aug 03, 2019, 6:50 PM UTC

threezero wrote: post #63

mevile wrote: post #45

If you're an employer in California and want to choose a provider that will not have to deal with this you might want to consider offering Kaiser to your employees. There's benefits and drawbacks, but one of the big benefits is that they're vertically integrated and the doctors, labs, pharmacies are all part of the same organization. I would think that would help avoid this specific type of situation. The big drawbac…

Kaiser’s system works better than a lot of others, but for me having to drive 40 minutes for a prescription is outrageous when I have 20 other pharmacies in a 15 minute radius.

If the outcomes are better and it saves a lot back and forth, it may be worth it?

At least they'll be encouraged to dispense more at a time (3mos vs 1month) to save their time and yours.

Re: Cancer patients are being denied drugs, even with prescriptions and insurance

#77

Post by Scoundreller » Sat, Aug 03, 2019, 6:51 PM UTC

sorokod wrote: post #3

Can't wait for the US health system to make it to the UK.

Higher public expenditures on health care for poorer outcomes?

Re: Cancer patients are being denied drugs, even with prescriptions and insurance

#78

Post by DanBC » Sat, Aug 03, 2019, 6:51 PM UTC

sorokod wrote: post #37

DanBC wrote: post #16

Earlier quoted context omitted.

Something similar used to happen here with NICE guidance not recommending use of the meds, which is why the cancer drugs fund was set up. After spending a billion or so on meds we found out that they mostly don't increase length of life and also cause nasty side effects. https://www.bmj.com/content/357/bmj.j2097

Can you explain in a bit more detail how NICE guidelines are similar to what is described in the article?

Firstly I'm only speaking about England. I don't know what happens in Wales, Scotland, or Northern Ireland.

Clinical Commissioning Groups should be following NICE guidance. If NICE looks at a medication and says it doesn't provide enough advantage for the cost they won't recommend it. That means CCGs won't always pay for it, and so hospitals can't use it.

Sometimes when NICE recommends a treatment the patient has a legal right to it, and the patient can pursue treatment if their local CCG is trying to avoid paying for it.

This cost:benefit calculation appears to be what's happening in the US. Except over here it's a public body making the decision and over there it's a private company.

Here's the NICE page for Pomalyst: https://www.nice.org.uk/guidance/ta427

> Pomalidomide, in combination with low‑dose dexamethasone, is recommended as an option for treating multiple myeloma in adults at third or subsequent relapse; that is, after 3 previous treatments including both lenalidomide and bortezomib, only when the company provides pomalidomide with the discount agreed in the patient access scheme.

That seems similar to the US? Only to be used after other meds have been tried, and only if the company supplies it at a previously arranged discount. (I didn't do much searching for this so maybe I've misunderstood the NICE guidance).

https://www.nice.org.uk/corporate/ecd4

> If NICE recommends the use of a treatment, the NHS Constitution says that it is your legal right to have it if your doctor believes it is right for you.

https://www.gov.uk/government/publications/the-nhs-constitut...

> You have the right to drugs and treatments that have been recommended by NICE for use in the NHS, if your doctor says they are clinically appropriate for you.

And here's a list of those treatments: https://www.nice.org.uk/guidance/published?type=hst,ta

Re: Cancer patients are being denied drugs, even with prescriptions and insurance

#79

Post by taneq » Sat, Aug 03, 2019, 6:52 PM UTC

surfmike wrote: post #51

taneq wrote: post #44

Earlier quoted context omitted.

The rational, informed decision is that the government should run its own medical R&D. But no, we can't do that because muh freedums.

You mean like the National Institutes of Health?

Yes, but more. You guys spend eleventy billion dollars on fighter jets with questionable hovering capability, can't you spend like four billion on nobody having cancer ever again?

Re: Cancer patients are being denied drugs, even with prescriptions and insurance

#80

Post by NotSammyHagar » Sat, Aug 03, 2019, 6:55 PM UTC

cheeky78 wrote: post #46

tasty_freeze wrote: post #36

One entirely maddening thing is that the ACA was labeled as having "death panels" that would decide who lives and dies. That phrase was powerfully effective in making large group of Americans strongly oppose the ACA. Even if they knew nothing else about the ACA, they knew they didn't want death panels. But as this article demonstrates, if we care to use the inflammatory "death panels" label, we already have them. It…

"But as this article demonstrates, if we care to use the inflammatory "death panels" label, we already have them." It's not inflammatory when it's true. When the government runs our healthcare, choices are removed and someone else gets to decide if you should get surgery needed or not...and many times this is life or death. At least now, if a cancer patient gets denied drugs, they can go to another doctor or get a se…

At best this is an uncommon opinion. I work with a dual citizen republican from Canada. He was almost swayed to your view until he actually used the us health system. We have good us Corp healthcare, & now he says it's similar to ca. He was wondering what would happen if he got hurt and lost coverage in the us.