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Saturday, August 16, 2008

Flowers To Comfort As We Contemplate...

From our perennial gardens, a little color with which to contemplate

This past week, the province of Nova Scotia (NS) announced a decision to begin to fund a drug called Avastin that is used in the treatment of one late stage cancer, called metastatic, colorectal cancer. It appears that the decision was made several months ago, and some time was needed in order to position the decision.

This drug costs $30,000 per patient, and will add from six weeks to several months to a patient's life. It will cost the province reportedly $5.3million per year for the program. This is a province that is in debt over-load; has about 2% of it's annual budget that is at all discretionary; has a medical and educational infrastructure that is in disrepair and disarray; and one in which it takes over a year to get a colonoscopy, or a virtual (CT) colonoscopy, and some six months to see a GI Specialist!

The province, with this decision has apparently already taken on the expense of retrofitting or outfitting several facilities around the province so the drug can be administered... at a cost of over $300,000. This expense was taken while the leadership was saying the decision was being considered. Clearly, the decision was taken after some very strong lobbying by some insiders... some of whom had, or were related to persons having advanced metastatic colorectal cancer.

Nova Scotia is one of only five provinces (out of ten) that funds this drug. It is also a province that does not have the money to afford such a decision. This is not a practical decision, it is an emotional decision that will cost the province $25 to $30 Million over the next five years. There will be no return on the investment. And it will not add to the quality or length of live!

On the other hand, it will prolong the process of death.

What are we thinking when we make these decisions? Certainly, it is an example of leadership not knowing when to lead. Leadership not knowing when to say no.

I know this seems harsh, and perhaps as a two year survivor of a potentially deadly form of cancer, I should be more accepting. Perhaps, knowing that my Mother is dying of a very similar form of cancer, I should be more willing to agree that Avastin makes sense. It just doesn't!

This money should be spent on the early detection and treatment of various curable health problems. If they want to do something in the name of those who have the late stage of colorectal cancer, memorialize them with an early detection program. Purchase endoscopic tools to do colonoscopies and find physicians who know how to use them. Purchase CTs to do virtual tours of patients bowels... we could be screening 50 suspected colon cancer patients an eight hour day with a CT, finding the cancers early and treating them... it is a very treatable disease if caught early.

I feel really badly for those with the late stage disease... but I feel worse for those who will go undetected in Nova Scotia and ending up getting Avastin!

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Grad. Saint Mary's University, 1975, got into the medical device business initially in sales, then various management positions up to president, all in Medical Devices. I prefer therapy products over diagnostic, but they are all fun, and in a way have defined my life. I have now evolved, with help from my 35 year partner Lynnda with whom I now share every hour. I am into staying healthy, photography, kayaking, bicycling, gardening and two books a week. I wish I had gotten to this stage earlier!