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Letters In Reply We appreciate the thoughtful comments of Grube and mor progression, poor prognosis, drug resistance, and shorter 1 2,3 Cardenas in response to our recent article. patient survival. Concordantly, positive expression of sur- We agree with the observation that many commercial in- vivin has been associated with a significantly higher risk of re- surance plans do cover the cost of secobarbital for use in aid- currence and decreased overall survival rates in patients with in-dying. Of the 35 patients at our center participating in the breast cancer. Although it is described as a biomarker predic- Death With Dignity program who were prescribed secobarbi- tive of aggressive cancer, survivin has been corroborated to be tal between 2010 and 2016, 12 patients (34%), all of whom had the key player of a mechanism by which myocytes at risk of commercial insurance, received some degree of coverage for apoptosis retain their viability. Survivin myocardial expres- this medication. Copayments for these 12 patients ranged from sion after acute myocardial infarction (AMI) has been related $2.00 to $1236.26. The remaining 23 patients (66%) either to the survival of at-risk myocardium and to a more favorable chose to pay cash for the medication
JAMA Oncology – American Medical Association
Published: Aug 8, 2017
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