What is time worth? Can you even put a price on it?

Drug makers seem to think so. A new article published in the Journal of the National Cancer Institute called into question the widespread use of expensive cancer drugs to prolong patients' lives by just weeks or months, according to this Wall Street Journal article.

The big number being trumpeted in news stories is $440 billion. Why? Well, treating a lung-cancer patient with Erbitux costs $80,000 for an 18-week regimen, they said, but prolongs survival by only 1.2 months.  Extrapolate that to extending the lives of 550,000 Americans who die of cancer annually by one year, and it would cost $440 billion.

The authors also noted that more than 90% of cancer medicines approved in the past four years in the U.S. cost more than $20,000 for a 12-week course.

Drug makers took issue with this, as would expect, and said the article "exaggerated the overall costs of their treatments because few patients are on them for extended periods of time." Is that because the patients die, or because they can only afford them for so long before they have to stop taking the drugs?

"Brian Henry, a spokesman for Bristol-Myers, said that the real-world price that patients pay for Erbitux is closer to $10,000 a month; the $80,000 figure that the article uses reflects a benchmark price known as average wholesale price that isn’t typically paid by anyone." Then why charge $80,000?

The article makes two related points. One, does the benefit outweigh the cost? Two, how much money are you willing to spend, and for how much benefit?

To the first point, the article quotes the JNCI authors:

"Many Americans would not regard a 1.2-month survival advantage as 'significant' progress," the authors wrote. "But would an individual patient disagree? Although we lack the answer to that question, we would suggest that the death of a mother of four at age 37 years would be no less painful were it to occur at age 37 years and 1 month, nor would the passing of a 67-year-old who planned to travel after retiring be any less difficult for the spouse were it to have occurred one month later."

This is something that has always bothered me about these drugs. Do you really want to spend your life savings and/or go into debt just to extend your life by a few weeks, which will likely be spent in pain?

To the second point, the article quotes an advocacy group leader:

"A drug like Erbitux is not very impressive when you look at the statistics, but for some it's just remarkable," said Robert Erwin, who heads the cancer advocacy group Marti Nelson Cancer Foundation. "How much does it cost for the person to have the opportunity to benefit, whether they get the benefit or not?"

Say that you're willing to spend a good chunk of money to get those last few weeks' worth of life. What do those weeks have to be like in order for you to fork over the money? Pain-free? Lying in a hospital doped up on morphine so you're not aware of your surroundings? Some pain, but able to recognize family members? And will the extra two weeks help you prepare - or, more likely, your family prepare - for death and help curb some of the sadness, or will it be just as sad as if you had died two weeks previous?

The WSJ Health Blog has a post on the same topic, and makes what I think is the linchpin in the whole issue:

"We can't add on Mercedes-like drugs one after another and have every single patient cost the system phenomenal amounts of money," Eric Winer, chief scientific adviser to Susan G. Komen for the Cure, a breast-cancer advocacy group, told the WSJ. "But we have to be careful not to slow down the process of drug development. Ultimately it is medical therapy that will make a huge difference in people’s lives."

Whether it's $80,000 for 18 weeks or $10,000 per month for a year, how do you put a value on those minutes? What is the price of an extra 1.2 months (about 65,700 minutes) tacked on to a year (525,600 minutes)?