Sunday, August 26, 2007

The PBS & mesothelioma drug treatment

The Age runs its normal pre-election, anti-Liberal Party line – this time Mr Howard (with all those budget surpluses) won’t interfere to ensure the PBS spend money to provide the drug Alimta, on a subsidised basis under a PBS listing, to unfortunate sufferers of mesothelioma. An editorial repeats these charges.

Drug firms seek to have their high-priced drug products listed under the PBS to sell them using public monies to meet required subsidies. Hence the PBS - not Mr Howard - screens drugs for effectiveness and value for money. The general idea is to maximisde health benefits per buck spent. Their assessment is that Alimta does not provide value for money and may not increase lifespan. The drug costs $20,000 per year of treatment and, acoording to one US study, can increase life expectancy by at most 3 months. It can also have adverse side effects. The detailed reason for the PBS’s Pharmaceutical Benefits Advisory Committee decision to not list Alimta is here. It has been put forward by its manufacturer (Eli Lily) 3 times for listing and is to be put forward again this November.

The scientific evidence discussed in the PBAC report is complicated. But none of this evidence is discussed in The Age’s article. The implication is that John Howard is just a cold-hearted bastard who won’t help those suffering from this awful disease. This is gutter journalism at its worst. As I have said before The Age is becoming one of the worst newspapers in Australia.

Mr Bernie Banton is a tragic sufferer of mesothelioma and a co-supporter with Eli Lily of listing Alimta under the PBS. He is a very brave man - and a battler who has universal public support and affection. He has done a lot to publicise the lot of those suffering from asbestos-related diseases and in dealing with the company, James Hardie, that inflicted this damage. Of course suffering from a disease does not make one an expert in evaluating treatments.

The Age should provide evidence that Alimta has health advantages that the PBAC has overlooked and which exceed the benefits from spending comparable amounts of money on the treatment of other diseases. Otherwise it should butt out and leave the cheap populism to nasty left-wing blogs.


derrida derider said...

While the Spring St Pravda's editorial pages are traditionally the most leftwing in the country, I don't think this is an example of that so much as just a "human interest" story - brave battler fighting unfeeling bureaucracy, etc.

Stories on exactly this topic with exactly this tone ("lifesaving drug refused by government beancounters") appear regularly on lightweight TV "current affairs" programs. It's more about gutter journalism than anti-government bias.

Francis Xavier Holden said...

harry I know that it's a diffucult time for the JWH sect but the "life saving drug" held back by "beancounters" and "administrators" is an old media standby.

If they could have mentioned Brumby, Bob Brown and Rudd they would have.

The amusing thing is that we have the journos preaching end times due to the proliferation of blogs that don't have the fact checking standards of MSM.

I don't know how long it takes a journo to write a piece like that. And I don't know what the unit cost of such as article is when you take into account subeditors etc. (It is clear that fact checking and research can't be costed in)

But I do know that an average blogger could do a more accurate article in a couple of hours after a hard days work and with no pay.

Francis Xavier Holden said...

oops - next time I'll read other commenters. Sorry DD

Francis Xavier Holden said...

I've just had a quick squiz at the PBAC paper - thansk for the link harry.

It apeas thast the AGE was worse than ignorant and "journo slacjness as usual" but dishonest. It took me about 6 minutes to ascertain that the drug combination if taken over up to 30 months (at a cost of about $2,000 a month taken) MIGHT add another (pain filled and with additional iatragenic complications) month (4 week, 30 days) to a terminally ill person's life.

hc said...

dd and fxh, You may be right that this is just poor journalism but the front page news story is a repeated series of attacks on Howard and to a less extent Abbot. It is almost every day these days.

The last sentence of the editorial attacks 'cold' economic rationalism.

The really nasty bit of this work is that meagre health benefits are held out to desparate people. Bernie I have seen on TV - he seems such an amiable decent guy. It is sad.

Anonymous said...

Enemy Combatant sez...

That's the trouble with all those Commies down at The Age; they havn't got a clue how to put a price on a working man's life.

Francis Xavier Holden said...

ec = I wasn't complaining about whether Bernie was a decent guy or argueing that he doesn't deserve help in his last months of life. (I don't think HC was argueing that Bernie shouldn't be helped) If the AGE is so concerned why don't they pony up the $20k for his medications.

In fact I don't think even Bernie was suggesting he couldn't afford it - he was touting for big pharma and requesting a change in PBAC guidelines.

Sadly even good people in the last months of their life can be wrong on policy.

[f'rinstance if HC was to notify us on this blog that he had caught a fatal strain of horse flu from sharing a needle with a memebr of CIS that wouldn't mean that I'd accept his view that JWH is equal to Christ, Ghandi and Jimi Hendrix or that there really are commos under his bed]

The AGE story is the worst kind of journalism. It's factually wrong and promotes false hope when all the evidence suggests that this drug at best, may only, give an extra month of life to someone suffering from a terminal illness.
(I haven't looked up the odds ratio and oaften papers these days will publish them, but I'm guessing it might be a 20 to 40 to 1 chance - that is an outside chance that ANY benefit would flow)

hc said...

I agree with you FXH but would go further in response to EC.

In health economics we do attach a price on death and suffering. There are not infinite resources so we do need to get the best value for resources invested.

As FXH's comment above suggests this drug Alimta seems to be quite expensive and to give only a small extension on life and seems to involve severe side effects. People with mesothelioma have a poor prognosis.

The PBS have made the determination that spending the money on other things would produce greater benefits. In the absence of alternative information how can I disagree.

The suggestion we are unsympathetic to Bernie is nonsense. A very decent guy and a tragic outcome.

Anonymous said...

EC sez...

fxh and hc, appreciate your comments. Got a reasonable slant on your orientations as human beings after a year or so of visting Oz blogs, and I don't for one moment believe that you bear Burnie any sympathy deficit.

Fxh: "If the AGE is so concerned why don't they pony up the $20k for his medications."

What about the outfit Bernie worked for when he contracted the asbestos induced mesothelioma, francis? Be nice if they'd chip in a few bob towards easing the burdens of Bernie's last days.

hc: "In health economics we do attach a price on death and suffering. There are not infinite resources so we do need to get the best value for resources invested."

That's where Bernie went wrong, Harry. He didn't have a grasp of "health economics". Coulda happened to any old revenue producing unit, I guess. Now Bernie’s government won't help with the medication costs.
Throughout his working life, the asbestos company got top ROI from Bernie. But at the end of the day he was just another Sicko. So they had to let him go.

As the govt. sits engorged on 17 Bill. in "Overs", Bernie's last days will be heralded in tabloid and on telly. Sure it's ghoulish, as you say, they’re mongrels at Pravda), but it's not what you'd call a good look for "compassionate conservatism", is it lads?

Francis Xavier Holden said...

ec said : What about the outfit Bernie worked for when he contracted the asbestos induced mesothelioma, francis? Be nice if they'd chip in a few bob towards easing the burdens of Bernie's last days.

I couldn't agree more. I think they should pay. (I think they might have given a payout already)

Even then tho looking at the evidence i'd suggest Bernie would get more out of blowing the $20k on a trip to Disneyland or Scores lap dancing venue in NYC, a few bags of quality Columbian Nose Candy, some good reds from australia, catching a live performance of The Holmes Brothers in NYC or George Jones and hiring a Swedish au pair in a short skirt ala Benny Hill, for his last few months.

Actually he can see The Holmes Brothers out here at the Corner Hotel on Sept 27 - 2007.

Anonymous said...

EC sez..

fx, lucky enough to catch 'em live 'em live at jazzfest NOLA 2003. Sen-bloody-sational. Their uptempo slide version of "Big Boss Man", the old Jimmy Reed standard, is as good as blues gets; and most of their gospel is sublime. Even better is Mavis Staples' recent album about the days she and Pops walked with MLK in the "freedom marches". Way things turned out, they did some overcoming, but in Katrina's aftermath, god's chillun still got a mite more overcoming to get done yet.

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