Michelle Diekmeyer lay awake in the dark, trying not to panic.
It was a struggle she seemed to be losing more and more every sleepless night in July 2005.
After all that, she still didn’t know if she’d survive the year.
But Diekmeyer had another, more immediate, fear keeping her up nights.
Because of mounting medical bills, she was worried she might lose her home.
The restabout $1,500was supposed to come from Diekmeyer.
Diekmeyer was too sick to go back to her job as a church secretary.
And she faced 10 more months of Herceptin and an unknown future of other treatments.
Still, Diekmeyer had no choice.
She either took the Herceptin or faced an almost certain death.
“How do I put a price on my life?”
Diekmeyer wondered, not for the last time.
“I can’t.
I just hope my doctors are patient about my bills.
There’s nothing else I can do.”
Other major drugmakers have similar programs.
“Is society willing to bear the cost of these drugs to save the lives of these women?”
asks Marisa Weiss, M.D., an oncologist in Narberth, Pennsylvania, and founder of BreastCancer.org.
“I say yes.
Medicine is not like other commodities, and those who need it are not like other customers.
The answerif there is an answeris something pharmaceutical companies, patient groups and lawmakers are struggling to find.
I think we’ve lost that.”
Extremely fast-growing, the cancer had already spread from the tissue of her left breast to some lymph nodes.
“The first thing I heard was that I’d be dead in a year,” she recalls.
“My husband started sobbing, and I just sat there for an hour, not moving.”
“Sometimes I wondered if it was worth it.”
Before she got cancer, Diekmeyer thought she and her husband were doing pretty well.
Otherwise, she didn’t worry much about her health care costs.
“We were comfortable but never planned for much beyond our regular bills,” she says.
“Then everything changed.”
Diekmeyer was covered under her husband’s health insurance, a plan that had always seemed adequate.
Now she watched her co-pays for doctor visits, hospital stays, surgeries and drugs add up.
Allotted 12 pills a month by her insurance, she sometimes needed twice that many.
“The first thing we always paid was our mortgage,” she says.
“I just couldn’t stand the thought of being this sick and having nowhere to live.”
Herceptin was no different: Genentech invested hundreds of millions of dollars over 25 years researching and testing it.
The drug industryand many patient advocatessee Herceptin as the model for the future of cancer treatment.
The eventual goal is to replace chemo altogether with targeted medications having minimal side effects.
“These are products you could’t compare to anything else.
They are changing the way cancer is treated.”
Herceptin costs so much partly because the market for it is not huge.
And because of the potential for heart damage, it is prescribed for only one year.
On the other hand, it’s not as though drug companies are struggling to turn a profit.
“So it’s not surprising that companies will charge what they think the market will bear.”
Which returnsus to the uncomfortable question: How much is a life worth?
Some patients do refuse expensive medications that would prolong their life by only a few months.
But that extra time can also make a huge difference.
“I know it costs a lot,” she said in the summer of 2006.
“But it’s my life we’re talking about.”
She was in a clinical trial for a ninth drug when she died that September.
For Osborne, whose insurance covered the drugs, the choice was uncomplicated by financial worries.
Many women are not so fortunate, a fact that drugmakers finally seem to realize.
“Three years ago, the question was, How high can I price my drug?
Now some are asking about the socially responsible and reasonable price.”
“We can’t just tell drug companies we want them to limit their prices.
That’s like leaving the fox in charge of the henhouse.”
Despite Diekmeyer’s struggles, the debate over drug prices to her is simply academic.
They cut off cable TV and stopped going out to dinner.
Now, after a year on Herceptin, Diekmeyer is almost paid up.
More important, she’s cancer-free.
“I know the pharmaceutical companies are profiting off my illness,” she says.
“But I’m so grateful they came up with this drug.
How can I also be angry that they’re charging so much?”
Photo Credit: Thayer Allyson Gowdy
