Sexy, right? Amazon sells a model with a larger pill capacity but this one screams “minimalist and sleek” to me. Why a pill box? Because my medications keep increasing in number and complexity. As food can have a big effect on how a medication is absorbed in your body, it’s important to take some medications based around meals. The most logical way to do this is to organize pills by mealtime in cute, colorful, OCD-inducing plastic boxes.

This week is Thanksgiving. 

Thanksgiving, as everyone knows, is a time to reconnect with family and friends by filling your plate with food and then sitting down at the dinner table to compare illnesses. 

Up until this year I’ve been the underdog in these conversations. However, this year is different! This year I get to slap my new pill box down and insert myself into the conversation with gusto! Maybe I’ll even raise the ante a bit and sneak a couple of placebo pills in as well!

Honestly, it’s a little disconcerting. In less than 6 months I’ve gone from no medications at all to enough to require, well, a pill organizer. My friend, Missy pointed out that it’s not forever. Retired from the Navy she used deployments as an analogy. She told me, “Deployments take two years. They suck, but in the end you get to come home and return to your normal life.” Coincidentally, my friend Pat who also has prostate cancer just ended his “deployment” and is doing great after concluding two years of treatments. 

So, what goes into my pillbox? 

The latest medication is Zytiga. Zytiga is used to treat aggressive prostate cancer, like mine. It along with Prednisone and the Firmagon shots that I started last week, complete the hormone therapy cocktail prescribed to me by my oncologist, Dr. Stewart. Dr. Stewart told me that Zytiga stops my adrenal glands from producing testosterone. If you remember from my prior post, testosterone feeds prostate cancer. Without testosterone the cancer should stop metastasizing and shrink. Zytiga is just another way of crimping the fuel line. One of the side effects of Zytiga is that it lowers the amount of cortisol produced by the adrenal glands. Cortisol, known as the “stress hormone” helps regulate blood pressure, metabolism, and stress levels. Sounds important, right? The Prednisone is a synthetic cortisol to replace what is lost when taking Zytiga. I also need to take vitamin supplements such as calcium to maintain bone density and prevent muscle loss. Zytiga can also cause high blood pressure and liver problems. While taking it I will need to monitor my blood pressure daily and have blood drawn every two weeks to check my liver function. 

Oh, and Zytiga costs $10,000 per month.

Yes, the zeros are in the right place. That’s roughly $160 per pill. I take two pills per night. My prostate cancer cells apparently have very very exquisite tastes. In retrospect maybe I should have bought a pill box with a padlock…

Zytiga isn’t even a cure for prostate cancer – it’s a treatment. 

I wish I could peg the blame solely on some greedy pharmaceutical executive somewhere pricing these things. In reality, I know that the truth is a lot more complicated than that. Zytiga, being approved in 2011, is a relatively new medication. Newer medications can take up to a decade and well over a billion dollars to get approved. Of all potential candidates only 10% are ever approved by the Food and Drug Administration ( FDA ) for the market. That’s a lot of money and a lot of risk. 

Thankfully, my health insurance helps a lot with the costs. I now understand why insurance rates increase annually as treatments like this skyrocket in price. No, it’s not okay and it’s definitely not sustainable but I’m at a loss how to fix the problem. 

Fortunately, there are people smarter than me working on solutions.

Last night after I choked down my jagged little pills Jodie showed me a study that she had found with an innovative solution for cutting costs.  Earlier I mentioned how some medications are absorbed differently based upon what they are taken with. Zytiga, for this reason, is taken on an empty stomach. The study found that if Zytiga were instead taken with food, the dosage could be halved and have the same overall effect. At $160 per pill the study estimated that the savings per patient were in the hundreds of thousands of dollars. Although the study hasn’t been clinically approved it is refreshing and a step in the right direction.

Take care. Stay healthy. Live life. Have a Happy Thanksgiving!

-Scott

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