Friday, 7 March 2008

Why Do I Cost You This Much?

The only reason I’m able to write this today is because I’m kept alive through an artificial form of nutrition known as Total Parenteral Nutrition, or TPN for short.

In early 2003 a massive blood clot led to me losing the majority of my bowel and as you no doubt know, without a bowel the body simply can’t absorb nutrition and without nutrition it's over and out.

TPN is fed to me intravenously through a line in my chest that goes directly into my subclavian vein. I need to feed seven nights a week and each bag costs around £120. On top of that are various vitamin and mineral additives that need to be injected into the bags along with heparin to stop the fluid from clogging in either the line or my veins, the syringes needed to do so, giving sets, individually packed sterile gloves and a sterile pack containing swabs, cotton wool, galley pots, forceps and sterile sheets. I also have alcogel, iodine, Mepore plasters, two types of sticky tape and tinzaparin injections, all of which are used on a daily basis, most twice daily. I also need to infuse a litre bag of saline daily. Every three days I use a morphine patch, I use a moisturising cream to prevent my skin dehydrating, a barrier cream when my bottom gets sore and I need Tegaderm whenever my entrance site – the place where the line enters my body – is likely to get wet. That would usually mean daily, but as I don’t have a shower and am too weak to get out of the bath, at the moment I’m managing with an old-fashioned strip wash so they’re not used as often. I can keep the water clear of the site when washing myself that way.

Anyway, all of this costs the tax payer HUGE amounts of money. My home care company once estimated that the total cost per day is around £200 – add that up and we’re talking £73,000 a year! On top of that, so far this year I’ve cost Mr and Mrs Tax Payer an extra £36,000 because I spent just over three weeks in hospital. According to the charge nurse on our ward, each bed costs around £70 an hour – yes, for ONE HOUR – to run and maintain.

Of course, I’m not alone. There are hundreds of thousands of people all around the UK receiving high-cost specialist treatment and millions more using the more conventional drugs, medicines and medical peripherals.

So why am I telling you all this?

Well what really started me thinking about it was an article in yesterday’s ‘Guardian’. Apparently, the company manufacturing Gaviscon, a remedy for indigestion that’s prescribed to tens of thousands of people, have been accused of deliberately stopping another company from launching a competitive product at a lower price, even though the government have long been calling for a cheap generic version. Apparently Gaviscon is cheap to produce but is marketed at a high price, making Reckitt Benckiser huge profits.

This isn’t the first time something like this has been highlighted, either, and begs the question of just how much tax money is being spent by the NHS in order to feed the rich and greedy pharmaceutical manufacturing giants through inflated prices.

I’ve never quite understood how a simple 2 ½ litre bag of fluid could possibly cost £120 and how can all those other things add up to £80 per day? They’re mainly just small plastic or paper items and a few fluids. Yes, they need to be sterile packed but even so, surely it doesn’t cost that much?

I hate being such a financial burden on our country, especially as I also have to accept living on state benefits AND drive a motability car, but I have no choice. Without the feed and medication I would die. Without money I wouldn’t survive long and without a car I’d have no means of getting out of the house. I have PVD too, y’see, so I can’t walk far.

I was angry yesterday and am still peeved today. That drug companies can do this with no thought for what that money they’re creaming off of our taxes could be otherwise used for is selfish and socially destructive.

Just think where that money could go. Improved education, better and increased social housing, improved home services for the elderly and infirm and so the list goes on. Just take your pick. But no…. social homes are difficult to come by, state education is in a dreadful mess, and the elderly no longer get free meals on wheels or home helps while the big bosses at the companies that are charging ridiculous prices for simple drugs and medical supplies are laughing all the way to the bank.

Sharon J


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Richard said...

You're worth every penny.

I don't think he drug companies are the sole villains. They would argue that without huge profits they would be unable to do the research and there is an argument that some drugs are very expensive because they have limited use, which is fair enough. But because that bitch who ought to have breathed her last yesterday but apparently only fainted encouraged a generation of talentless "entrepreneurs" (i.e. middle men) to get involved in absolutely everything using the cover of being part of the "service industry" costs skyrocketed because everyone needs to make a profit. And that is disgusting.

Sharon J said...

Well of course the drug companies aren’t the only ones who are up to this kind of thing, it just happened that this post is specifically about them rather than generalising the situation as a whole. You know from personal experience that I’ve never been happy about the costs surrounding my being here and yesterday’s article made me very angry.

As for research, yes of course it’s to be done but considering Reckitt Benickiser made a net profit of 674 million pounds in the 2006/07 tax year attributable to equity holders then that is no excuse for selling a simple formula such as Gaviscon at hugely inflated prices!

As for the “bitch that fainted”, I take it we’re talking about Baroness Thatcher? I just want to make that clear for the benefit of my overseas readers who probably don’t know about her little episode.

When you say these “entrepreneurs” were using the cover of the “service industry”, what do you mean exactly? Are we talking about the service industry as in that they’re part of the tertiary stage of economic activity (selling on) because if we are, what does that actually have to do with production and distribution, which is where this particular problem lies?

I’m by no means saying that the service industry isn’t part of the mass consumption problem that’s wrecking the planet at the moment, but your comment has confused me in that I’m not quite getting the connection with my post.

Sorry. Maybe I’m just having a “dim” day.

beanpole said...

I bet the cough medicine i bought this morning that cost £3.20 only cost about 40p to make then. Thats a lof of profit.

You really seem to know your stuff sharon. Where do you get all your information from?

Vicus Scurra said...

the queen costs more than that, and she's not even funny.

Sharon J said...

Beanpole. It may well have only cost 40p to produce but there are packaging, distribution and point of sale costs to take into account too and often it's the profits made at the point of sale that are the greatest. I've no doubt there are inflated profits being made on it, though.

As for my information, I use the Net, books and I talk to people. Everybody has some knowledge on something's that's worth knowing.

Ken. At least the queen does a few things to bring some of that money back into the country whereas I do Jack Shit!

the anners said...

Sharon, this is amazing information. The medical mysteries in our world are always surprising me, and you are a new one! Last night on 20/20 I was watching a bit about a woman who developed epilectic seizures whenever she heard music, and she had to have a chunk of brain removed in order to continue on in life. Regarding your situation, I am also shocked that a bag of fluid could cost so much. I am sure that drug companies charge that much because they CAN. People need these healing solutions, and there is no other choice than to pay what is required to obtain your sustenance. And with no competition to lower prices, the demand for limited production will remain. It's really something that should be regulated by government. I believe that in the US, there is a certain time period where competition for a new drug is not allowed for the first three years or so, but after that, the market is fair game. At any rate, you are such a lovely person, and I'm glad that there is a solution for you, regardless of its cost.

Richard said...

Extra levels of distribution whether it's for services or products I mean. For instance, homecare companies don't really need to exist but because departments within the NHS have to "compete" with each other it's cheaper to farm out services which, in turn, have to make a profit. We've come to accept this as normal but so much of it is unnecessary.

Sharon J said...

TA. It surprised me that they were able to keep me alive, too. When I woke up after surgery and was told they'd removed most of my bowel, my initial thought was that there was no way I'd be able to survive.

You're right about companies charging inflated prices because they CAN. It's very selfish but the human race consists of many selfish people so I doubt that will ever change. We only have to look around our immediate environments to see that.

I'm sure the market's open here too but companies take steps to ensure that their potential competitors can't undercut them. As in the case of Gaviscon, where they simply changed the formula slightly.

Richard. Thanks for clearing that up. I understand what you're getting at now.

Clinovia are undoubtedly making their share of the profit and that's understandable. I wonder whether that profit has changed since BUPA bought them up? The level of service certainly fell for a while but it seems to be back at their pre-BUPA level again now.

If you ask me - which you haven't but I'm going to tell you anyway - privatisation of public services was one of the worse things that happened to this country. I believe the Baroness had a huge role in that, too? Damned woman!

Chris said...

Hi Sharon!

A very interesting post!

I know my feed system costs a lot too and I am always angry when it is changed that nothing can be sent back! Unopened boxes of items are not good enough to be used due to infection risks and the fact they were prescribed for me! Even syringes, in date pre packed formula feeds the lot! Find good homes for it abroad is the answer to that one but I still feel some it is wasted when it could be used here too!

A part box of syringes is now going back to the dietitian for "training" purposes! well that IS a good idea as they need lots of training sessions with community nurses and others too!

Thanks as ever for your informative blog! Love reading it!

Will be in touch after my stay in the NHS hotel! Trouble is not too sure how many ***** out of 5 it will get in my post when I return home!

Take care


PS plan for a trip to Crewe in April!

Sharon J said...

I read your comment Chris and went straight to my drawer, took out a syringe and studied it. It’s completely packed in so obviously still sterile, and if it wasn’t then it would be just as much a danger to me as to anybody else. Now, assuming we both know the proper routines (which, of course, we do) and have alcogeled our hands before touching anything, if I pass this unopened syringe to you, you then open it and use it, how exactly are you going to become infected with anything? One of life’s little mysteries, I guess ;-) The staff on the ward during my recent hospital stay were more sloppy about things than I am and I’m sure the same goes for you, too. Still, at least using them for training purposes is better than dumping them.

Can anybody out there explain this? Because the more I hear about all this waste of resources, the angrier I get about it!

Larrieale said...

I am on 4ltr TPN every night, I recently had a house fire and smoke contaminated my treatment room and everything in it (even though the fire was downstairs ). All my equipment and ancillaries were written off and had to be replaced. My insurance is asking for the cost,my question is cans/sould he cost be claimed on my policy, and who does the money go to, my supplier, who claims the cost back off the NHS, or me?