As I turned off a highway last week, there was a man standing on a small island where the exit merged with a main road. He held a sign saying that he would work for food.
For some reason, I began to think of a recent article that had appeared in the New York Times (April 25, 2013) written about the high cost of cancer drugs. The article, entitled: “Doctors Denounce Cancer Drug Prices of $100,000 a year,” talked about the movement among influential cancer specialists to try to force the drug companies (what some folks call, Big Pharma) to reduce their prices.
It led me to wondering how many of us would be willing to work a second or third job to help pay for the cancer treatment drugs of a relative or a friend? I think that most of us would do so. Then, of course, I began to wonder about profit motives and the ethics of charging and over-charging for a dose of a drug that would help to keep a friend or a relative alive. How would I feel about working 18 hours a day to help pay for a cancer drug that I knew was earning a pharmaceutical company billions of dollars a year in profits?
The ethical debate has so intrigued me that instead of doing my formal “Chuck Gallagher” post on the topic, I’d like to pose a series of questions in the hope that it will stimulate the discussion since the topic of cancer drugs will become a reality for many of us.
Though I would wish otherwise, some of us will face chemotherapy if not for us, then for someone we love. Life and death and the promise of sustaining life and “avoiding” death are not light-hearted ethical topics. As a prostate cancer survivor I know all to well the challenges that face us when we are diagnosed with the big “C”…
Who Are You?
For this ethical debate, we can take three different positions. None of them are wrong – and none are without fault. If you would like, you can be a major pharmaceutical company, a cancer specialist, or a patient. Let the ethical Chuck Gallagher ethical blog debate begin!
- Let’s say you are a pharmaceutical company, and you have just spent the last seven years developing a new cancer drug. By last count, the research costs have been $250 million and there has been no return. Are you not entitled to make a profit if the drug is approved by the FDA? Suppose you are a publicly-traded company and you have shareholders. Is it ethical to your shareholders and investment bankers to intentionally reduce profits after they have loaned you money?
- Suppose you are a cancer care specialist. You may be an oncologist, radiologist or any related area of expertise devoted to the treatment of cancer. You have signed an international petition demanding Big Pharma reduce its chemotherapy costs by one-third or more. It is a noble sentiment and you feel darn good about it. But what about you, doc? Having had medical challenges myself I, Chuck Gallagher, had to review your invoices as well. You are also not cheap. My question is a simple one, doctor: if you ask the pharmaceutical companies to reduce their fees by one-third, should you do so as well? If my car mechanic charges me $1,000 to completely overhaul my car, why are you charging my insurance $75,000 to administer a series of injections?
- Suppose you are the patient. Your insurance (and I am not approaching this politically), has informed you that your co-pay for a “miracle drug” is $1,250 a month and that treatments will be on-going. While you are able to work, you still have a mortgage, a car payment, possibly tuition and other costs. What do you expect? Should you get free treatment? A further reduction in treatment? If you feel as though you are being gouged by the medical establishment, would you accept these same arguments in regard to your profession? For example, you are a realtor and you work on 6 percent commission. A client feels you are gouging and asks you to do the ethical thing and only charge 3 percent. Is that acceptable to you?
These points of view are overly simplistic, I know. Feel free to take another position or to add more complexity. You may also take more than one position. This is an ethical debate that centers on a common theme: How much is saving a life worth? What is the price tag on a life – and more importantly, who should pick up the bill?
I encourage your observations and ethical opinions. YOUR COMMENTS ARE WELCOME!
