December 27, 2020
How much is a life worth?
I’ve been thinking a lot about this lately. I remember being horrified when I learned there was actually a method to figuring out how much a human life was worth. It seemed so wrong. To put a monetary value on life was just mind boggling. Then I realized there are some practical reasons for it from a societal point of view. I get that, but still find it disturbing.
The most recent estimates I find are that a human life is worth $10 million. There are all kinds of caveats to this, we’ll just say this is the current general estimate for the U.S.
As I finish out cycle 19 of my medication and treatment since my diagnosis (19 cycles at 4 weeks each is a little over 17 months), I have a bunch of thoughts that run through my head. How long will this medication work? Will I develop new side effects from it? What happens if we have a life change and the insurance won’t cover costs like they do now?
That made me start thinking more about how much it is costing to keep me alive. What an odd thing to write. The medication is only one part of the cost. I have monthly doctor visits and additional treatment. I have not had to have any surgeries or procedures since my July 2019 diagnosis but I do have multiple scans every 3 months.
I will state that I am EXTREMELY fortunate and privileged that we have private insurance through an employer that covers the vast majority of costs. That doesn’t mean that this is free - everyone is paying for this treatment through high insurance premiums and health care costs. The pharmaceutical companies are making a huge profit off these life-prolonging medications. (Note, they are not life saving, just life extending.) The overall health care industry is profiting over the fact that I have stage 4 cancer and want to live as long as possible. The company that makes my CDK 4/6 inhibitor (Pfizer, makes Ibrance) had revenue from just Ibrance of over $1 billion in 2019. This statement (below) from the linked article is so disturbing. Ibrance is a medication that is only used to treat stage 4 breast cancer. The more sales they have means the more people are taking it. They make money if more people need to take it. (They also try to take the market share of the other 2 brands of CDK 4/6 inhibitors manufactured by 2 different companies.)
Ibrance: $1.3 billion, up 13%, missing analyst estimates of around $1.35 billion, although Pfizer noted that sales were 14% higher in the US mainly due to CDK class market share gains (FirstWord Pharma, by A. Bratulic)
Ok, so back to the cost of my medical intervention for 2020. These are rounded numbers that are based on the insurance statements. The dollar amounts are what was charged. Our insurance has negotiated rates, so they don’t pay this much. However, if you did NOT have insurance, these amounts are what you would be responsible for.
Oral medications. I take a CDK 4/6 inhibitor (Ibrance) for 21 days (with 7 days ‘off’) and I also take an aromatase inhibitor (Anastrozole) every day. These are the medications that have stopped/slowed progression of the cancer. A 28 days supply of Anastrozole is ~$20, one cycle (21 days) of Ibrance is just over $12,900. So, for the year the cost of these medications was ~$168,000.
Monthly visits. Visit to oncologist, monthly blood draw/lab work, infusion of Zometa (bone strengthener) and shot of Lupron (to induce menopause) ≅ $10,000. 13 visits means a total of $130,000. (Recall I am on a 28 day treatment cycle so it’s just shy of a month that I have appointments.)
Scans. I have a CT scan with contrast coupled with a bone scan. The CT scans are done at the cancer center and the bone scan in the nuclear medicine department of the hospital. The fees cover all scans plus the radiologist to read the scans and write the report. Each time I have these scans it costs just over $7,600. I had scans in February, May, September and December for a total of ~$30,400.
This brings my total direct cancer related costs to $328,400 for 2020.
The indirect costs are higher. We’ve changed the way we eat and our food is more expensive. I’ve passed on career opportunities that would probably equate to a higher salary in the near future. My kids are not always dealing with this well and as a result we have medical expenses related to getting them help with coping with this horrendous situation.
So, how much is a life worth? I don’t think we can or should put a number on it. My life is worth so much more than the cost associated with treating the cancer. I like to think my contributions to my family and society are worth more than the cost of keeping me alive. This brings up an important point though. Of the $328,400 that it costs to stop the cancer from taking over my body, other than monthly insurance premiums, we paid $0. Our deductible was covered by Pfizer. This is a special situation they have for clients who have private insurance. Interestingly, they do not offer the same benefit to anyone who does not have private insurance (medicare, medicaid, state insurance programs).
We are fortunate and privileged. We are grateful as well. However, our situation with insurance coverage does not make my life more valuable than someone who does not have the same insurance. We know our situation can change in a heartbeat and so we take nothing for granted.