Distributive Justice - Bioethics in Medical Practice

Distributive justice concerns the equitable distributionindividuals can afford these drugs. Medicare and
of scarce resources among all socioeconomic groupsMedicaid cover prescriptions for Avastin and Erbitux,
and population sectors. The question of distributivefor example, but copayment costs frequently put
justice is a key ethical consideration in all aspects ofsuch medications out of reach for many. Those who
medical care, including assisted reproductiveare uninsured, of course, cannot even consider taking
techniques and reproductive genetics.on the costs of these cancer therapeutics.
Access to cancer pharmaceuticals are a primeIf we are an ethical society, concerns about
example of violations of distributive justice. Thesedistributive justice extend to those living beyond our
drugs typically cost tens of thousands of dollars ashores. Treatment for HIV/AIDS presents a classical
year. Some costs are stratospherically high. A newexample of ongoing violations of distributive justice.
drug, Folotyn, manufactured by Allos Therapeutics, isFor instance, sells a 90-day supply of Atripla for
projected to cost about $30,000 per month.(1)$4937 (less than $1650 per month), an inconceivable
Remarkably, Folotyn hasn't been shown to prolongcost for persons living on less than $2 per day.
lives - its effect is to shrink the tumors caused byAlthough steep discounts are provided by
peripheral T cell lymphoma, a rare disease affectingmanufacturers for those living in developing nations,
5000-6000 Americans each year.even a cost of $1 a day (the price for many
Erbitux, used in the treatment of colon cancer, costsgenerics) is much too high. To a great extent, the
approximately $10,000 per month. Avastin costsHIV/AIDS pandemic persists owing to the lack of
almost $100,000 per year when used to treat lungavailability of appropriate medication. Global
cancer or breast cancer.pharmaceutical corporations receive hundreds of
Society as a whole bears the burden of thesebillions of dollars in annual revenues. They have the
enormous expenditures, reflected in annual increasescapability of providing medications at a de facto pro
of 10% or greater in health care insurance premiums.bono rate to developing nations. Distributive justice
In essence, every taxpayer in the United States isrequires they engage in such activities.
helping to maintain the profit margins of theAs we'll explore in our next article, access to assisted
pharmaceutical companies that impose such highreproductive techniques is similarly affected by
prices.inequitable distribution of services.
In terms of distributive justice, cancer medications(1) Pollack A: Questioning a $30,000-per-month cancer
are simply not available to those who can't afforddrug.
them. At costs of $10,000 per month, very few