An expensive potion

I was interested to read yesterday of the hope of sorts being offered people in the US with early-stage Alzheimer's by a new drug called Leqembi. With the hope taking the form of approval from the FDA and of Medicare saying that they would pay, that is to say for those who, for one reason or another, have not got proper health insurance of their own. Presumably the regular health insurers have yet to set out their stall.

There seem to be three big catches. First, the new drug only slows things down a bit. It is not a cure. Second, there may well be unpleasant, not to say dangerous, side effects. Third, it is very expensive, with a year's treatment costing of the order of $90,000 - with this last figure including, as well as the costs of the drug itself - perhaps $25,000 - all the support services that should come with it.

From where the thought pops out that in this country, at the point of delivery, the idea is to minimise the costs. While in the US, where all is done for profit, the idea is to maximise the costs - with the result that their health costs roughly twice as much as ours.

There is a small fourth catch, in that administration takes the form of intravenous infusions every two weeks. Speaking for myself, needles not good - although maybe if I had Alzheimer's, that particular problem would go away. And lastly, it is not clear whether the drug is suitable for those on blood thinners. Another issue for me.

VFM

Leaving aside the question of who pays, there is still the question of value for money. Is this a good way to spend our health money? Hard to know how one would react if one was diagnosed, but on the face of it, value for money does not look great. I think FIL, had he been given the choice when he still had some mind left, would have declined and suggested that someone got to work with a pillow at the appropriate time. He had seen far too much dementia is his working life to want to join that particular club himself.

Against all that, one might argue that one has to go through with these early efforts so that things get better later. Glad that it is not my call.

References

Reference 1: New Federal Decisions Make Alzheimer’s Drug Leqembi Widely Accessible: The F.D.A. gave full approval to the drug, but added a black-box warning about safety risks. Medicare said it would cover most of the high cost - Pam Belluck, New York Times - 2023.

Reference 2: https://www.cms.gov/. The people who, inter alia, do for Medicare what NICE does for the NHS. At least, I think so.