Targeted cancer treatment

Q: My sister-in-law was diagnosed with chronic myeloid leukemia, and she’s taking the targeted therapy Gleevec, which is working unbelievably well. If the Affordable Care Act gets repealed and she gets bounced off the insurance rolls, she could end up paying up to $160,000 per year to stay alive. What can she do?

A: First of all, we’re glad your sister-in-law found a successful targeted therapy. Gleevec (imatinib) works by destroying a specific protein that causes the leukemia cells to grow out of control. Some reports say that it’s helped 83 percent of patients live 10 years or longer.

As for drug costs, NBC News reported that it costs the drug manufacturer, Novartis, $159 to make a one-year supply of Gleevec! When it introduced the drug in 2001, the price tag was $30,000 annually. That price has increased by 10 percent to 20 percent every year since then. Now insurance companies can be billed between $140,000 and $160,000 annually. Fortunately, generics have been approved, but that hasn’t dropped prices dramatically, despite the fact that one generic sells for around $400 annually in India and $8,800 a year in Canada. Novartis took in $4.7 billion in 2012 from sales of Gleevec, according to The New York Times.

But, for those on Medicare, the price of Gleevec varies depending on what phase of drug coverage they’re in and if they take generic or brand. Insurance coverage through the Affordable Care Act varies from state to state. Corporate insurance plans may have their own deal. In short, it’s a mess.

No wonder most folks don’t understand the insurance debate! In fact, a survey by a nonpartisan digital research company found that 45 percent of those questioned didn’t know that if Obamacare was repealed, the ACA also would be repealed. They had no idea that ACA and Obamacare were the same thing!

We hope that if the ACA is repealed, there will be someone who can negotiate and make a deal for fair drug prices for the American people.

Q: You hear about so many infectious diseases spreading from the tropics. I even heard that yellow fever in Brazil could spread to North America. In our area, tick-borne infections are affecting thousands of people. What’s going on?

A: It’s true that there’s a potential threat of many diseases, such as Ebola, Zika and West Nile virus, and now the increased incidence of yellow fever in Brazil, that we in North America haven’t had to deal with before. And Lyme disease — more homegrown — is now thought to affect around 300,000 people a year. What’s going on is that changing environmental conditions seem to be making such potential problems ever more common.

That is one reason 11 top medical societies, representing more than half of U.S. physicians, have released the report “Medical Alert! Climate Change is Harming Our Health.” They want to “help patients, the public and policy makers understand the damage climate change is doing to people’s health and what needs to be done to prepare and protect ourselves.” (Online: http:// bit.ly/2mSN3MZ.)

The report says that climate change is increasing the risk for cardiorespiratory illness associated with wildfires and air pollution; heat injury from extreme heat events; the spread of infectious diseases, such as West Nile virus and Lyme disease; and health and mental health problems caused by floods and extreme weather.

According to Mona Sarfaty, M.D., director of the consortium of medical groups: “Here’s the message from America’s doctors on climate change: It’s not only happening in the Arctic Circle, it’s happening here. It’s not only a problem for us in 2100, it’s a problem now. And it’s not only hurting polar bears, it’s hurting us.”

Your best bet: Cover up and use DEET to deter mosquito- and tick-borne illnesses; keep your immune system as healthy as possible by avoiding the Five Food Felons and walking 10,000 steps a day — and let your representatives know of your concerns.