Dewey, Chetham, and Howe at it again

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Postby Kevin Mackie » Fri Oct 07, 2005 7:09 pm

Since the vaccine will save many lives and countless millions in medical costs that are picked up through insurance/Medicaid etc, why wouldn’t insurance companies/the government offer this vaccine for free? The only reason why not is unless the aggregate cost of the vaccine equals or exceeds the cost of treatment of the disease. I doubt that’s the case. So there’s a windfall somewhere to be had by someone. Why not send it back to the payers of the treatment, i.e. the insured and the taxpayers?
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Postby Bill Glasheen » Fri Oct 07, 2005 7:38 pm

Kevin wrote:Since the vaccine will save many lives and countless millions in medical costs that are picked up through insurance/Medicaid etc, why wouldn’t insurance companies/the government offer this vaccine for free? The only reason why not is unless the aggregate cost of the vaccine equals or exceeds the cost of treatment of the disease. I doubt that’s the case.

Actually, Kevin, if this vaccine did indeed save money on the net, then it would be the exception and not the rule. Many people don't realize this. Even if it means they don't have to do PAP smears any more, they won't be able to stop those for another generation. Millions of women around the world already are infected with HPV, and they are carrying a ticking time bomb.

There are very few therapies that save money - particularly when you factor in the time value of money. The only ones that do are vaccines like that for rubella where the mom gets sick AND delivers a baby with birth defects. Otherwise... In the world of health care, a treatment that costs $20,000 per quality-adjusted year of life saved is considered a really good deal.

That's why your insurance keeps going up every year.

Check out this article.

..... The Price of Prevention

If I am not mistaken, this eBook is based on a similar article published in a paper edition of Scientific American. It shows the math, and dispels a lot of myths.

Here's another interesting one to consider. Did you know that killing tobacco today would cost the government a fortune? Between having to pay 7 more years of social security and losing the tax revenue, they would be in a big heap of trouble if suddenly all these well but old people were on their hands. No wonder they love Big Tobacco! It is a sad irony.

Whenever some vendor or doctor came in to our Blue Cross plan and said they were going to save us money with treatment, we were usually prepared to hold on to our wallets and/or run out the door.

Don't get me wrong though. I think ALL kids should get these vaccines before their sexually active years. HPV infections for both men and women are at an epidemic level, and women are becoming sexually active earlier and earlier. It is a silent epidemic that kills women years later, and it's getting worse every year.

- Bill
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Postby IJ » Sat Oct 08, 2005 8:30 pm

http://cancercontrolplanet.cancer.gov/a ... l.jsp?ac=1

(you have to click on cervix to see the stats)

It's not all bad, at least for these USA rates. Cervical cancer is one of screening's great successes. Breast is another. Prostate is up in the air and may help or harm. Lung so far is a wash.

However, this would be great for those countries that don't screen, and its much simpler to get a shot than to face yearly paps and the resulting tests and procedures (remains to be seen how it would change pap recs). Plus, there's no pap for anal cancer which this would presumably prevent as well. Watch for it to be priced by costs saved and not be development / production costs.
--Ian
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More bad news for Vioxx

Postby IJ » Sat Dec 10, 2005 7:23 pm

http://www.forbes.com/technology/ebusin ... 79934.html

http://content.nejm.org/cgi/content/abs ... EJMe058314

The second one is an early release, public access editorial from the NEJM editors expressing their concern that some heart attacks were omitted from the VIGOR study by MERCK (employees of whom were key authors, not just sources of funding).
--Ian
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