Consider this, you're a multinational company peddling a relatively new melanoma cancer drug that's been effective for one out of three users. You obviously want a foothold in a country that has the highest melanoma rates in the world but the Government won't publicly fund your drug because it's not satisfied that it's the most effective on the market.
For the one in three it works for you offer, through an oncologist, a deal that would more than likely ferret out those who the drug doesn't work for. The patient pays for the first two or three weekly treatments at a cost of $8,500 a pop.
After six weeks the desperate cancer sufferer would more than likely know whether the drug's effective. For those who've reacted well, understandably they're desperate to continue, so the drug company offers an incentive, to fund the next two treatments.
By that time the patient's been on the drug for twelve weeks, and is showing dramatic signs of improvement, so they willingly pay $17,000 for the next two treatments.
And if they're still on the mend after that the drug company offers another two treatments on the house.
Obviously by that time the improving patient's hooked, but for the next year they're on their own, when it come to paying for the treatment. Then if they require it for another year, the drug company pays for every third treatment.
Before you start thinking about how generous the drug company is, think of the clinical research it's just carried out, partially funded by the patient.
That's exactly what's been happening to Tauranga math teacher Leisa Renwick who doesn't see herself as a guinea pig, but as a survivor - and who can blame her? She was told last May she had just days to live.
America's Merck, Sharp and Dohme is one of the biggest pharmaceutical companies in the world and it produces Keytruda, the drug Leisa Renwick's thankful for. It's a drug that works for one out of three users and she's the lucky one.
It's competing here with another drug giant based in the Big Apple - Bristol, Myers, Squibb - which produces Opdivo, a drug that claims to do the same thing as Keytruda and is also wanting to establish a foothold in this market.
Remove the emotion from the debate, and there's been plenty of silly political point scoring on this, and put yourself in the Government's independent drug buying agency Pharmac's position.
Whatever decision it makes on funding a melanoma drug, and that it will, there'll be losers - the patients who it doesn't work for. But there'll be a winner alongside those who've responded to the drug, the pharmaceutical company that wins the contract to supply it at an exorbitant cost to the totally vulnerable patient.
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