That proposed new cholesterol drug

No I don't have high cholesterol (one ailment that I do not have) but I have been reading the stories on the new recommended cholesterol drug. On one hand it makes sense that other cholesterol drugs are needed besides statins. Not everyone tolerates them, about 10% don't in fact. And some people have genetically high cholesterol.

Fine, I get it. But this new drug doesn't impress me. Why?

1. Because it is an injection. 
2. Because it is expensive.

I hate injections. My husband does my weekly methotrexate injection. It would be much easier if it was oral. Needles are a pain to deal with. And I hate needles. And disposing of them and getting shots and just icky poo!

Also, cost is a real issue.

"If the new drugs are approved, it is estimated they would cost between $7,000 and $12,000 a year per patient. In comparison, statins cost between $48 a year (for generic forms), up to between $500 and $7,000 a year (for brand-name drugs)."

That's a big increase. I realize that it won't be as cheap as a generic but what about developing an affordable medication? And an oral pill for $48 or one or twice monthly injection for $7000-$12000? Seriously?

However, "if we [balance] the cost of these drugs over society and the cost to our health care system for caring for patients who suffer the consequences of vascular disease," Antman said, "it's possible that the calculus would suggest this could be a cost effective and attractive approach.""

Blah, blah, blah. The cost to society? Sure. I get it but what about the cost to the patient? And why should that be part of the pricing equation? 

In a normal world, not biotech or pharma, pricing is done for a lot of different reasons. Everything from market placement ('if its expensive it must be good' is a real thought process) to basic cost and supply and demand. In the dream world of medication pricing, these basics are evidently thrown out the window. 

Anyway, I think I will consider new medications as news when they are affordably priced. And I need to stop whining about medical costs, I know but the whole issue just pisses me off. And if I whine about them, I can avoid thinking about my own medical crap.

Medical School

Although I was designated the office doctor last week, I am now going to medical school. It started yesterday and continues for the next 7 weeks. Someone referred me to it a while back and I registered at canvas.net and now it starts.

I was traveling yesterday so I haven't had a chance to start my first class on Anatomy and Physiology. It should take me an hour or so each week. I am looking forward to it. The other courses are a second week in Anatomy and Physiology, Cellular and Molecular Biology, Immune System, Infectious Disease, Neuroscience and (my favorite) Cancer Biology before finishing up.

Why am I adding to my busy schedule with mini-medical school? Because I hope it will help me understand my body and why it keeps on having so many issues. I figure I am a prime candidate to learn about medicine as I seem to have a lot of interaction with the medical profession.

What I really want is a cure for all that ails me but I doubt that will happen anytime soon. But in the meantime, I can be smarter.

Excuse me while I take a nap

So I am traveling, in fact on the way home. I got to see relatives I never see. But I don't travel well because I need to nap. I arrived Thursday evening and went to bed early. Then Friday I took two naps. Saturday morning I slept until after 10. Then I needed to lie down before going to dinner and then going to bed early. Sunday I also took a nap.

I interspersed my naps between fun things but still I was horizontal often.  I also found that I get very tired while driving.

I may have to curtail my driving adventures in the future, which is no fun. But today I did drive through the Elk and Buffalo prairie at land between the lakes on the TN/KY border. If you are in the area, its worth the stop. And I didn't have to get out of the car to watch a whole herd of about 40 buffalo.

That was pretty neat but now I need a nap as I sit here waiting for my flight. Maybe I am turning into an old fart. (No don't answer that, because if you are my age, you might be an one too.)

I'm travelling

I'm traveling. But my husband is home with the cats. This means I got up way too early yesterday, 4am to be precise, for my early non-stop flight (because of my lymphedema) so I could drive 200 miles after visiting the Country Music Hall of Fame. Then I drove over 200 miles across three states to get to visit my aunt and cousins.

I am tired. I don't travel well. The airport check in was surprised at how small my checked bag was. I can't deal with a big piece of luggage anyway. And I figure the world is full of laundry machines when I travel by myself.

I did get a good nights sleep and will be okay. We wanted to do gardening today but since its raining, that will have to wait.

Office Doctor

My co-workers have a sense of humor, especially about my health issues. And they don't know half of them.

Two of them were talking. One said 'go ask Caroline, she's the office doctor'. Apparently since I have 'every medical ailment known to mankind' (their words), I have the most medical experience and should be consulted on any medical ailments.

I guess I got a promotion.

Lets talk about drugs and their pricing

There is new talk about looking more at drug pricing. This also applies to other drug pricing.

Okay, here's the discussion. If drug A costs $1000/patient per month and drug B costs $300/patient per month, drug A is obviously much more expensive than drug B. But if B doesn't work quite as well as A, there is a problem. Because if B results in quality of life issues and hospitalizations and shorter survival rates, there will be additional expenses so the cost savings is not there any  more.

So now the proposal is that we must look at toxicity and efficacy. This means that we need to look at issues such as quality of life, hospitalizations, and survival rates.

I like this idea. If a less expensive drug has more adverse reactions, is it better to go with the more expensive one? I think that depends on the side effects. For example, I have two rheumatoid medications. One of them causes me to have a suppressed immune system and I end up with a bad cold that lasts a week or two, every couple of months. But the other one can cause nausea (my favorite) and is harder on my liver, and may not keep my RA suppressed as much.

So I have to decide which is better for me. Lots of colds which cause lost income etc or bits of nausea, potential liver issues, and RA pain.

I am still on the fence about this one.

And the same applies for breast cancer treatment with Tamoxifen. This is the baseline drug for preventing recurrence. But if the side effects are too much and end up affecting the patient's quality of life, is it better to switch a newer, more expensive alternative?

But others are promoting more discussion on this topic.

Hope

The one thing we all have to keep at all times is hope. Yes, hope. We all must continue to believe there is a rosier life out there for us.

But for a cancer patient, we must keep our hopes alive. What do I hope for?

• A cure for cancer
• My cancers do not come back

Two hopes. Nothing fancy. Two little phrases. Very simple. I work on these two hopes differently.

First I read medical research but do not obsess about it. I read about on going research and upcoming developments. I read about doctors' opinions of the research as well. I know not all research is going to help me. Some of the research may not pan out. Some of it will pan out but wont be available to patients for another 10-15 years.

But all of it gives me hope. I can see progress in the works to make sure fewer people go through medical misadventures, heal better, have a better prognosis, and lead healthier lives, even with a cancer diagnosis.

Second I do everything I can to make sure my cancers do not come back or reappear elsewhere in my body. I try to take care of myself. I go to the (damn) doctor as often as I should. I take my prescriptions. I go for suggested tests and other fun misadventures. I get exercise. I eat right (mostly). I do my best.

By being proactive in my health, it allows me to feel comfortable that I am doing all I can to make sure my cancers do not reappear. Or if they do, they will be caught early.

Hope is optimism and I need to keep it close in my life.