What’s Your Life Worth?

A growing number of doctors and other health experts warn that the health system simply cannot continue to pay any price, no matter how high, for specialty drugs. The country has to brace itself, they say, to face some hard medical and ethical choices.

“We want to pretend that health care is a right above money, but we charge very aggressively for everything we use in health care,” says Leonard Saltz, M.D., an oncologist at Memorial Sloan-Kettering Cancer Center. “America needs to confront the enormous amounts of money we are spending on these treatments.”

“Every time we pay for a high-priced drug, we should ask, ‘Is it worth it?’ Even in health care, that’s a fair question,” says Arthur Caplan, director of the Center for Bioethics at the University of Pennsylvania.

Some national health systems in Europe, such as the United Kingdom’s, have refused to use some of these new specialty drugs, saying the medicines do not offer enough value for their price.

Some drugs are highly effective, but others offer what Caplan calls “limited and debatable” benefits—extending life by weeks or months—at a cost of $200,000 for treatment. Now doctors who once took pride in not knowing or considering the price of a therapy “are recognizing that discussing the cost of a drug should be an important part of providing good care,” says Neal J. Meropol, M.D., an oncologist with the Fox Chase Cancer Center in Philadelphia.

He says the medical community is moving to a cost-effectiveness approach that will weigh a drug’s cost against a year of quality life. “There is a groundswell of demand now for studies to tell the physician how much bang you get for your buck with these drugs,” Meropol says.

Barbara Basler is a senior editor on AARP Bulletin staff.