Orphan Illness

The cost of health care in the U.S. is currently 16% of G.D.P. and projected to consume 25% of G.D.P. by 2025. Controlling the cost of health care is not just a U.S. concern, but worldwide.

To wage this war on health care inflation, the Spendulus Bill allocates $1.1 billion of the total $787 billion to compare the efficacy of drugs, medical devices, surgery and other ways of treating specific conditions. A total of $59 billion in the package is allocated for health care.

So what about the rest of the $59 billion? The bill allocates $20 billion to move us towards E.H.R. (electronic health records) which are supposed to save significant dollars in the big scheme of things, but even that is questionable.

So $787 billion distills down to $59 billion to tweak a portion of the economy that consumes 16% of the G.D.P.

Of that $59 billion they propose to use $1.1 billion to study the efficacy of health care treatment protocols.

Seems to be upside down in my opinion, but what do I know?

Already we are seeing fallout from the spending bill and it's impact on medications that may never reach the market. Drug giant Pfizer has pulled the plug on two drugs that are in the research stage.

The good news is, newer drugs usually cost more and may not be any more effective than current treatment protocol. Eliminating marginally effective drugs can be a good thing for your wallet.

The bad news is, if you have an orphan illness, one that afflicts only a small portion of the population, you may miss out on a new medication that might actually work.

Fibromyalgia is "a condition characterized by long-standing pain, has been the subject of controversy over its legitimacy, despite being recognized as a disease by the FDA and insurers." But fibromyalgia, once thought to be psychosomatic, only affects a relative handful of people.

There are two drugs on the market that have received F.D.A. approval for treatment of fibromyalgia . . . Lyrica and Cymbalta.

A 30 day supply of Lyrica runs $75 while a 30 day supply of Cymbalta is $125. Is one more effective than the other?

Like many illnesses, it varies by individual.

Would Esreboxetine, the Pfizer drug that is being shelved any better than Lyrica or Cymbalta?

We may never know.