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Cited from: http://www.nytimes.com/2008/07/06/health/06avastin.html?_r=1&hp&oref=slogin July 6, 2008 Costly Cancer Drug Offers Hope, but Also a Dilemma By GINA KOLATA and ANDREW POLLACK 1. Soon she was having tests to reveal the extent of the cancer and hearing the grim results. 2. And so, like many others in that situation, Ms. Reeh, the vivacious owner of a staffing agency in vivacious vigorous and active 3. Approved for patients with advanced lung, colon or breast cancer, it cuts off tumors’ blood supply, an idea that has tantalized science for decades. 4. Studies show the drug prolongs life by only a few months, if that. 5. While many patients and their doctors say the drug can improve the quality of life—like a sense of well-being and an ability to carry out daily tasks without exhaustion or pain—such effects can be hard to document. 6. Meanwhile, many patients with cancers other than those of the colon, lung or breast are taking the drug, even in cases where there is no compelling evidence that it can help. 7. “It’s not a slam dunk and, in fact, the incremental benefit may be more modest than we want to admit.” slam dunk something that is a sure to occur; a foregone conclusion; in basketball, a dunk shot carried out with great force; something dramatically successful and effective ( informal ) 8. But like a half-dozen or so new biotechnology drugs with a similar combination—alluring promise, high price and only arguable benefits—Avastin raises troubling questions: What does it mean to say an expensive drug works? Is slowing the growth of tumors enough if life is not significantly prolonged or improved? How much evidence must there be before billions of dollars are spent on a drug? Who decides? When, if ever, should cost come into the equation? 9. If her insurer did not pay, she said, she would go into debt, find a way to raise the money. 10. But some in the pharmaceutical industry worry that such prices will raise concerns about whether the drugs are worth it, leading to a backlash like price controls or restrictions on use. 11. “There is a shocking disparity between value and price,” he said, “and it’s not sustainable.” 12. Some patient advocates are also troubled by very expensive treatments like Avastin coming into routine use on what they see as little more than a hope and an expensive prayer. 13. “It’s absolutely critical that we start having a public discussion,” said Barbara Brenner, executive director of Breast Cancer Action, an advocacy group. 14. Cancer drugs constitute the second biggest category of drugs in the 15. Spending on drugs for cancer grew 14 percent last year, faster than for all but three other diseases. 16. If Avastin is approved for those earlier-stage patient groups, it could have a major impact in delaying the return of their cancer, but hundreds of thousands of additional people could end up taking it, possibly for years. 17. And that, insurers and patient advocates say, could impose a considerable financial burden. 18. “Think about where the interests are aligned,” said Dr. Deborah Schrag, a colon cancer specialist at the Dana-Farber Cancer Institute in 19. Doctors want to help them and may be financially incentivized. Incentivized to give incentives to: The government should incentivize the private sector to create jobs. 20. And, like Medicare, private insurers may in turn require patients to pay a percentage of what can be hefty bills. |
Your card is maxed out. 你的卡刷爆了. 這是相當正式的講法, 一般你如果去 grocery store 買東西, 信用卡不能用, 店員只會以同情的眼光看著你說, "I am sorry, your card won't go through." 或是 "Your car is not approved." 然後就看著你手忙腳亂地找現金給他. 這句話也常用主動的講法, 例如, "I maxed out my card." Cited from: http://som.twbbs.org/klee/notebook/ |
