I've been a big proponent of this idea for several years. The idea that life saving new and wildly expensive technologies that benefits a small population of people is exactly paralleled by existing Medicare coverage of dialysis for ESRD and is best funded by spreading the cost and risk over the entire US population. Individual employers and even most health plans will struggle to pay for these therapies as well as justify the in year cost vs the lifetime quality of life and cost benefits that are likely to accrue to society but not the entity that is footing the bill.
Curing sickle cell, cystic fibrosis and the array of other lethal genetic diseases was unthinkable when I was in medical training and now that several of these are here and more will come to market over the next few years is an amazing advance.
Yes- the law of large numbers would make it much easier to spread the risk for the cost of these treatments across the population. I think the pharma innovators could be paid well, too, and wouldn't have to worry about intermediaries, coupons, and collection risk. Thanks for this comment.
Thank you for sharing this rationale on how these high-cost pharmaceuticals will affect the actuarial tables of insurance products! Very relevant to current work going on abroad on how national health insurance programs are struggling to create financing mechanisms to fund these much needed, yet prohibitively expensive treatments.
I've been a big proponent of this idea for several years. The idea that life saving new and wildly expensive technologies that benefits a small population of people is exactly paralleled by existing Medicare coverage of dialysis for ESRD and is best funded by spreading the cost and risk over the entire US population. Individual employers and even most health plans will struggle to pay for these therapies as well as justify the in year cost vs the lifetime quality of life and cost benefits that are likely to accrue to society but not the entity that is footing the bill.
Curing sickle cell, cystic fibrosis and the array of other lethal genetic diseases was unthinkable when I was in medical training and now that several of these are here and more will come to market over the next few years is an amazing advance.
Yes- the law of large numbers would make it much easier to spread the risk for the cost of these treatments across the population. I think the pharma innovators could be paid well, too, and wouldn't have to worry about intermediaries, coupons, and collection risk. Thanks for this comment.
Thank you for sharing this rationale on how these high-cost pharmaceuticals will affect the actuarial tables of insurance products! Very relevant to current work going on abroad on how national health insurance programs are struggling to create financing mechanisms to fund these much needed, yet prohibitively expensive treatments.
Here's an interesting article from 2009 about the challenges faced by Costa Rica to afford an effective but very expensive medicine for a rare disease. https://blogs.bu.edu/maks/files/2013/01/GenzymeGlobeArt.pdf
It makes sense to sell drugs to much poorer countries for a lower price. This is already done with drugs for TB and HIV.