Is the Profit Motive Harming and Killing Cancer Patients?

“It is difficult to get a man to understand something when his salary depends on his not understanding it.” – Upton Sinclair

Here is a shocking fact you most likely did not know: Unlike other kinds of doctors, cancer doctors (oncologists) are allowed to profit from the sale of chemotherapy drugs. In fact, most of the annual income oncologists earn comes from the profit that they make from selling these highly toxic drugs to their patients.

That’s not supposition on my part. That’s a fact reported by NBC Nightly News back in 2006. You can watch the report here:

http://www.msnbc.msn.com/id/14944098/ns/nightly_news/

As NBC reported, oncologists buy chemotherapy drugs at wholesale prices and then sell them to their patients at “marked up prices.”

This absurd practice was made legal years ago after Medicare and health insurance companies decided it would be a good idea to move cancer patients out of hospitals and into the care of private practice oncologists. Their reasoning was that this was necessary in order to save money. What happened as a result of this misguided decision was the exact opposite.

Instead of saving money, the cost of chemotherapy drugs skyrocketed to tens of thousands of dollars a year, and in some cases, tens of thousands of dollars per month.

Medical ethicists have for years questioned the wisdom of allowing oncologists to continue to earn the majority of their incomes from the sale of chemotherapy drugs, correctly pointing out that doing so creates a serious conflict of interest between patient welfare and oncologists’ desire to prescribe the drugs that they are going to make the most money from even when they are not what their patients needs.  This includes over-prescribing drugs beyond the point in which they are effective.

How many cancer patients have died because their doctors succumbed to the lure of maximizing their profits and administered chemotherapy drugs inappropriately?

No one can say, but in all likelihood at least some cancer patients did die because of their doctors’ desire for profits.

This is a travesty and it needs to stop!

Correctly this great wrong won’t be easy, however, nor can oncologists as a whole be blamed.

Although I strongly disagree with the use of chemotherapy drugs the way they are administered by conventional oncologists—for the simple reason that, in the majority of cases, they do not work—at the same time I recognize that most cancer doctors and their staffs are extremely dedicated professionals who are doing all they can, based on how they have been taught (persuaded, would be the better word) to treat cancer.

In short, it’s not oncologists who are at the root of this problem; it’s the system in which they are trapped!

This fact was admitted to by Dr. Peter Eisenberg, a conventional cancer specialist who was interviewed as part of the NBC report mentioned above. In it, he said, “Patients should feel that their physician has their best interest at heart, always. And the way the system is set up, because of the incentives [for selling chemotherapy drugs to their patients], does something to destroy that.”

So, what can be done about this?

The first step appears clear-cut. The profit motive for oncologists must be eliminated in the arena of cancer care, by eliminating their ability to buy drugs at wholesale and then to sell them at often much higher prices. (Note: Usually, it is not the cancer patients who pay these exorbitant prices; it is health insurance companies and/or Medicare/Medicaid. The end result is higher health insurance premiums for all of us, and a further drain of taxpayer money from our federal government’s already overstrained resources!)

Oncologists must return to administering their drugs in the same way that all other MDs do: Instead of selling drugs directly, they must simply prescribe them, as they once used to do.

But this step alone, will not fix the problem, and here’s where things get more complicated. And more suspect.

You see, the real reason cancer drugs cost so much has very little to do with how much it costs drug companies to develop them and bring them to market. Nor does their cost have anything to do with their potential to save lives. If that were the case for chemotherapy drugs, their price would be extremely low given how abysmal a track record they have for improving cancer patients’ quality of life and extending their survival rates, let alone actually curing cancer, which they most certainly do not (at best, they only temporarily put cancer into remission).

No, the real reason cancer drugs in the United States costs so much (well over $100,000 a year for a single patient in the case of many of the new generation of cancer drugs) is very simple:

Cancer drugs—especially the new generation of drugs—cost so much because they have no competitors.

In other words, drug companies can charge whatever they want for their cancer drugs, and they do exactly that!

You might think that such price-gouging by the drug companies could easily be curtailed if health insurance companies if they simply refused to pay the prices Big Pharma demands for their cancer drugs. In theory, this is correct, but the reality of this situation paints a different story. First, refusing to pay the cost of cancer drugs would garner a lot of ill-will towards health insurance companies by the public, and these companies already have enough of that as it is.

But the bigger issue has to do with Medicare. You see, when it comes to paying for the price of drugs, both cancer drugs and otherwise, health insurance companies take their lead from Medicare. Medicare does not provide coverage for most types of drugs, but it does cover the use cancer drugs. Most health insurance companies simply follow the guidelines for drug reimbursement that are established by the government’s Centers for Medicare and Medicaid Services (CMS). And when it comes to the price of cancer drugs, as far as CMS is concerned, anything goes!

This is in stark contrast to how CMS acts with regard to all other types of drugs. Aside from cancer drugs, CMS controls medical costs by establishing the fees that are paid under Medicare/Medicaid for nearly all other medical procedures, including drug usage, by both doctors and hospitals. Once CMS establishes these fees, health insurance companies set their own rates of coverage to coincide with them.

What this means is very simple to understand: If CMS dealt with the price of cancer drugs in the same way that it does for all other medications, the price of cancer drugs would quickly plummet, largely sparing oncologists of the temptation to try and profit from their use.

When it comes to cancer drugs, CMS must change its policies!

Then there is a third, and equally important factor to consider: The Pharmaceutical Research and Manufacturers of America (PhRMA). PhRMA bills itself as the pharmaceutical industry trade group. In plain English, it means that it’s a drug lobby. And since 1992 its work has paid huge dividends for Big Pharma, from which its funding is derived. You see, PhRMA convinced the US Congress and President Bill Clinton to enact a bill known as the Prescription Drug User Fee Act (PDUFA) of 1992. Once the act was passed and signed into law, Big Pharma effectively became the fox guarding the henhouse of the Food and Drug Administration (FDA). This came about because the act means that, since its passage, Big Pharma actually helps fund the FDA’s research and approval process of the very pharmaceutical drugs the FDA is supposed to be regulating on our behalf. Not only does Big Pharma’s funding of the FDA create a direct and serious conflict of interest, it also ensures that the FDA provides a speedier approval process of pharmaceutical drugs, many of which later prove to be ineffective, life-threatening, or both!

By now, I’m sure you can understand that one of the most serious underlying problems that have kept conventional cancer treatment in the US focused almost entirely on dangerous and ineffective cancer drugs is the fact that cancer is big business. Hundreds of billions of dollars are spent each and every year on behalf of cancer patients and their loved ones who are desperate to reverse this terrible disease. And all of that money winds up in the pockets of the doctors and clinics that treating cancer with these cancer drugs, and, most especially, the pharmaceutical drug companies who manufacture them and promote their use.

Human nature being what it is, it would be foolish to expect those who profit most from the use of these cancer drugs, including oncologists, will suddenly change course and start investigating the cheaper, safer, and far more effective cancer treatments that I have spent decades of my life investigating. Not when their livelihoods depend so greatly on the status quo of cancer care today.

Therefore, it is up to each and every one of us to pressure our elected officials to clean up this sad state of affairs that we are in. To do so, we must insist on the following:

• Oncologists must be prohibited from buying and reselling cancer drugs for profit.

• The Centers for Medicare and Medicaid Services must begin to establish the fees that are paid under Medicare/Medicaid for cancer drugs and cancer treatments, just as they do for all other drugs and medical procedures.

• The influence of Big Pharma and their lobbyist group the Pharmaceutical Research and Manufacturers of America must end, both at the FDA, and within Congress (the drug lobby has more lobbyists in Congress and spends more lobbying money there than any other lobbyist group), and the Prescription Drug User Fee Act of 1992 must be rescinded.

If we as a nation can achieve these goals, then truly effective approaches for treating cancer in the United States may at last come into the full light of day.

God bless,

Burton