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Health insurance to cover new cancer therapy worth ¥33 mil

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Maria: "So, if someone receives the treatment here and pays their 10 - 30 percentage, but the treatment doesn't work, will that money be repaid?"

Nope. But if it was the hospital's fault and they killed you, you might get a bow and an apology.

0 ( +0 / -0 )

My understanding is that in the US it is Novartis, the manufacturer, which does not charge if it doesn't work. 

So, if someone receives the treatment here and pays their 10 - 30 percentage, but the treatment doesn't work, will that money be repaid?

0 ( +0 / -0 )

Swiss pharma priced it at $475,000 with a money-back guarantee to hospitals if it does not work.

https://pharmaphorum.com/news/novartis-matches-gilead-kymriah/

Hope to see this carry thru for Japan.

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My understanding is that in the US it is Novartis, the manufacturer, which does not charge if it doesn't work.  I suspect the same will be true for Japan.  Of course I could be wrong.

1 ( +1 / -0 )

It's expensive, but when you need it, it pays off - I've faced a 7 digit bill already covered mostly (thankfully) by the Insurance.

It does not appear to be out of control like the US system of insurance, but is otherwise rather boring.

0 ( +0 / -0 )

In the US, the treatment is free if it doesn't work

Really? That is what the news is saying;

But it comes at a cost. The drugs are hugely expensive. Kymriah and Yescarta cost $373,000 to treat adults with advanced lymphomas, while Kymriah costs $475,000 to treat acute lymphoblastic leukemia in children and young adults. In addition, many patients experience serious side effects that can land them in a hospital intensive care unit for weeks, pushing treatment costs more than $1 million.

“Medicaid has been very tough,” he said. “Certain states just deny coverage, even states with balanced budgets.”

In other words, the US government is not covering it some private plans are but you still have to pay for it. even if it does not work.

https://khn.org/news/staggering-prices-slow-insurers-coverage-of-car-t-cancer-therapy

1 ( +2 / -1 )

In the US, the treatment is free if it doesn't work. I don't know if that will be the case for Japan.

That will never happen in Japan.

0 ( +0 / -0 )

What it leaves out is the fact that, in exchange for a mere few receiving this specialized treatment, they want insurance to stop covering prescription drugs if those drugs or products are also available over-the-counter. So, the compressed (shippu) and other things MANY people go to the doctor and get prescribed, or regular médicine, will no longer be covered.

1 ( +1 / -0 )

In the US, the treatment is free if it doesn't work.  I don't know if that will be the case for Japan.

0 ( +0 / -0 )

I have to wonder if this is has been influenced by the case of the swimmer Rikako Ikee, recently diagnosed with leukaemia?

-1 ( +1 / -2 )

@the resident. I do indeed have evidence but it is from a doctors forum that that could be very serious for me if I disclose. But I will try to give some links tonight if you are so pessimistic. If I don’t have time stay tuned. You guys/girls seem to cast doubt. Ie...Fukushima radiation is non exixtanat. I have just been there for research. Try...Location: Tomioka (500m from JR Station, Joban line), Fukushima, @1cm

This is nowhere near the same as making a statement of fact that leukemia is increasing in Japan!

3 ( +3 / -0 )

Great news, well done Japan.

One of the most important piece of info is missing from this article though: J got a very good deal/price! In comparison, "Kymriah costs $475,000 for those with ALL and $373,000 for DLBCL" in the US. (Kymriah's approved for 2 indications i.e ALL mostly kids & young adults & DLBCL adults ).

This reuters article has a much more thorough explanation than JT's

https://www.reuters.com/article/us-novartis-kymriah-japan/novartis-gets-approval-to-sell-kymriah-in-japan-for-306000-idUSKCN1SL057?utm_campaign=pharmalittle&utm_source=hs_email&utm_medium=email&utm_content=72699792&_hsenc=p2ANqtz-_Ms9dStNk-_9fpnjS_2ubMaZ7ay07qTjWYD2LV3lcS9xEwA_D0ZYhZEYoo-vyQxKlGdDuIS9RTYbu9guFay9M1xUMjQpT0ZCEn0T1vfG5EdSbXCYQ&_hsmi=72699792

0 ( +1 / -1 )

The age cap may seem low because these cancers move more aggressively in the young, and more slowly in the older? Don't quote me on that, just a possibility.

2 ( +3 / -1 )

This is excellent news. Having witnessed my father die of Leukemia 30 years ago and since following the developments of treatments in detail I am always amazed by the progress that has been made in what is such a (relatively) short time. That these drugs ARE being made available is a big positive. I would like to know the amount of 'average' insurers in the US, or how many 'postcodes' offer this in the UK for example.

@obladi: Yes - there is a risk of death as you point out. There is also a risk of death walking out your door. But, it is not your call to make, a person who has no other choice but to make THAT choice would view it very differently.

5 ( +6 / -1 )

I'm all for immune-based therapies, but CAR-T cells have a risk of killing the patients. What I am worried about is a complete reversal if this happens in the early days of this new technology.

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Health insurance!

Don’t I pay for this out of my salary every month?

Why should I pay more? Their should be no distinction and covered and non covered diseases and conditions.

Adding clauses should be illegal. The pharmaceutical corporations already and would still make enough.

-4 ( +1 / -5 )

There is also a cap on monthly medical payments depending on a policyholder's income. For example, a patient with annual income between 3.7 million yen and 7.7 million yen, would have to shoulder costs of roughly 410,000 yen a month to be treated with Kymriah.

This is a VERY confusing statement here. It is a one time treatment drug, so this payment should not be a "monthly" payment, but a one time payment.

4 ( +5 / -1 )

.

Great news !

For one thing : Clinical tests of Kymriah, ... show that 'around 80 percent of those suffering from leukemia and some 50 percent of those with lymphoma saw significant improvements in symptoms.'

Secondly , eligibility includes 'children and those 25 or younger with B-cell precursor acute lymphoblastic leukemia and patients with diffuse large B-cell lymphoma, who are not able to be cured using other anticancer drugs.'

.

1 ( +2 / -1 )

Good.

4 ( +5 / -1 )

This is great and hopefully with more developments the cost of the therapy will drop. I am curious as to why the age cap is 25 though? I would have thought something like 45 and under considering all of the parents with young children to provide for who have one of this awful diseases could probably benefit from this as well. Perhaps the benefit is less the older you become, not enough information from the article. Either way its a good start and any advancements in cancer treatment is a blessing.

3 ( +4 / -1 )

At 216 patients a year.... you're looking at a yearly cost of around $6.5 million. I say give these people a chance and I'm happy they've seen fit to help them out.

12 ( +13 / -1 )

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