I am now taking a medication once a month to manage a symptom of a slow-growing cancer that I have. I just started Medicare last year and see by my statements that the cancer center charges my Medicare an enormous sum of money for this treatment and my oncologist says that there is not a generic equivalent that can be administered this way. Is it ethical for them to charge this sum (over $10,000) for an injection and is it morally "acceptable" for me to take this, at great cost to my fellow taxpayers?

It is very good of you to pay attention to these costs borne by others -- most people don't. Given the amount involved ($120,000 per annum), I think you should make an effort to find out more. Your oncologist says that no generic drug "can be administered this way" -- well, is there a compelling reason why it should be so administered, or would you be equally well off with the generic product administered in some other way? It is quite possible that your oncologist makes a lot more money from giving you the expensive medication rather than the cheaper one, so explore the question on the internet and perhaps also ring Medicare to get their opinion. If we all pay attention in this way, then it will be much harder for pharmaceutical companies and medical providers to overcharge the system we all pay for.

If the expensive drug you are taking really is the only way to manage the symptom in question, then I would expect this symptom to be serious enough to justify this lavish reimbursement. But perhaps the symptom isn't very bad and the treatment is reimbursed only because of some corporate lobbying? If so, you might well forego the treatment and even question more generally its use in cases such as yours. On the other hand, if the treatment makes you feel and function much better, then you are surely entitled to it. You should then not feel bad about the cost you are imposing on the rest of us, for the roles might easily have been reversed with you contributing to the cost of relieving my severe cancer symptoms. If the treatment helps you substantially, I for one am willing to help pay for it (and so are, I daresay, most others).

Is it unethical to charge $10,000 for an injection? I cannot answer this from the facts you provide. I am sure that the marginal cost of producing the fluid injected is a tiny fraction of $10,000. But then it may have been very expensive to develop and test this treatment, in which case the price tag might be justifiable. Or the price tag may be the result of lobbying and corruption, in which case it would not be justifiable. Again, you might spend a little time on finding out more.

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