Charles Engelke’s Blog

December 23, 2005

Neulasta

Filed under: Personal — Charles Engelke @ 5:34 pm

Treating cancer is expensive. I knew that. But I can still be shocked. Really shocked. $5900 for a single shot shocked!

You read that right. The bill we got for a single 6mg injection of Neulasta was $5900. That’s a bit less than $28,000,000 per ounce. Of course, you don’t just get the 6mg of Neulasta; it’s diluted in solution. Perhaps a fairer way to look at the cost is by volume. That’s only about $50,000 per teaspoon. (Don’t spill it!)

Luckily, we don’t have to pay that much. First of all, Laurie’s insurance has a discount negotiated with the doctor, and the discounted price is only $3687.50 per injection; barely more than $17,000,000 per ounce or about $30,000 per teaspoon. (Medicare gets an even better deal: $2938.40 per shot. Drugstore.com charges about the same “low” price as Medicare.)

In fact, we aren’t having to pay a cent. Laurie’s excellent insurance has a $1500 per year “out of pocket” limit. We hit that almost instantly once she was diagnosed with breast cancer, and everything since then has cost us nothing. (We’ll start paying again in January until we hit the limit, which will happen very quickly.)

Still, it’s not free… everyone is paying for it via health insurance and Medicare taxes. Is it worth it?

Yes. I’d like it to be cheaper, and hope it will get cheaper. But it’s worth it, and we’d pay that much out of our own pockets if we had to. Even if we had to go into debt to do it.

Put it in perspective. Laurie’s going to get six chemotherapy treatments, with an injection of Neulasta after each of them (yesterday was treatment number 3). Chemotherapy is extremely tough on the patient. Laurie’s mother had it in the late 1970s, and when she had a new cancer in 1990 she said at first that she would rather die than go through it again. (Unfortunately, the cancer advanced so fast that time that it turned out not be an issue.)

But the only side effects Laurie has been having from her chemotherapy treatments are hair loss, a day or two of queasiness, and several days of fatigue. (The effect has been that her 4cm lump has shrunk to the point where her oncologist can’t detect it any more with manual examination.)

In short, chemotherapy has been wonderful for Laurie. And Neulasta is undoubtedly one of the reasons for that. It keeps her immune system strong, even though the chemo is breaking it down.

Neulasta doesn’t get all the credit for the lack of side effects (and it doesn’t get any credit for the effect, either). Still, it’s worth the $18,000 or so the full six doses would cost at discount (Medicare or Drugstore.com).

The chemo treatments themselves seem to be costing about $8000 each, discounted to about $5000 to our insurance. So the course of 6 chemo treatments will come to about $30,000.

Neulasta plus chemo will cost $48,000. For the last few weeks, I’ve seen the stupid “December to Remember” Lexus commercials over and over again, suggesting buying a Lexus on a whim as a surprise present. A Lexus GS 300 costs about the same $48,000.

The price for the treatments don’t seem so bad anymore.

December 13, 2005

Celestron SkyScout

Filed under: Gadgets — Charles Engelke @ 10:26 pm

Can this be real? I can’t wait to find out.

December 2, 2005

Ubuntu!

Filed under: Notes — Charles Engelke @ 4:05 pm

Last weekend I setup up a server with Ubuntu Linux, and it has just blown me away! Not so much as a server operating system, but as a desktop.

I needed to get an Internet web server up for a demonstration of bid-based cost estimation. I was away from the office, so I didn’t have time to give IT any notice of the need. So I figured I’d use my own Internet server to host it. But there were problems. Really, just one problem: the demo needed to use MySql, and I couldn’t compile it on my OpenBSD server. There is a MySql binary package available that I could have installed… if I were on a more current version of OpenBSD. And I didn’t like to idea of upgrading the operating system on a public server that’s already in use.

I’d bought a really inexpensive Gateway server a couple of months ago ($199 plus shipping!) so I finally unpacked it and started to set it up. I burned an OpenBSD boot CD-ROM, since I’m comfortable with that OS, and its security, and started the installation. But OpenBSD couldn’t see my Serial ATA hard drive. I could have fiddled with the BIOS to make the drive look different to the OS, but after a few tries, I knew I wasn’t getting anywhere. So I decided to install Linux.

I’d read people raving about Ubuntu, so I downloaded and burned an installation CD, and fired it up on the new server. The installer asked me about three questions, then installed everything perfectly. Not only did I have the core OS, I had a really nice GUI and a full set of applications (Firefox web browser, Evolution e-mail, OpenOffice suite, and many others).

It’s really easy to use, and I think it’s suitable for non-technical users. And it runs my demonstration really well, even though the server has only 256MB of RAM. The application is faster than on my Windows PC with 1GB of RAM.

I highly recommend Ubuntu to anyone who wants to set up an easy to use, stable, and inexpensive PC.

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