"Most insurance companies do not cover the oral treatment, or only a small part of it, which means that many colon cancer patients will have to come up with thousands of dollars to pay for the Eloxium. Dad's oncologist is furious about it because she'll have to force patients over to the oral medication. There'll be simply no choice once there's no supply. Even worse, if a patient begins the Eloxium, there's no going back, even if Culovort becomes available again."

Erin said slowly, "So mortgage your home to pay for the treatment of a life-threatening disease, and have a nice day."

"Can you imagine, Erin, not only dealing with chemotherapy and all the brutal side effects, the possible prospect of dying, your family's grinding fear, the unending stress, and then being told that one of the major components of your chemotherapy course isn't available anymore because of unexpected production problems? And, oh, yes, sorry, but on top of all that, it's going to cost you a bundle out-of-pocket to switch over to a new chemo drug."

Oh, yes, she could imagine it. She remembered all too well her father's final months, the soul-draining helplessness they'd all felt watching her father become a frail old man, so ill he couldn't eat, so weak he could barely stand. She remembered how he'd told her late one night that this damnable cure made you forget the disease, you felt so rotten. She swallowed down tears, shook her head. "What I really can't picture is a group of people actually sitting down and deciding to simply stop making an important medicine for cancer patients, people who may already be staring at death from the doorway and trying to deal with it."

Dr. Kender smiled at her, a charming smile that for an instant erased the terrible fatigue and worry from his eyes. "Ah, you're forgetting the bankers on Wall Street. They purposely set out to make all the money they could, and they didn't seem to give a damn about the consequences."

Erin sighed. "I'm beginning to wonder if greed has any limits at all."

He said, "We are the ones who have to set those limits. Controlling and manipulating access to drugs for profit is wrong, but at least it affects a finite number of people. The bankers have damaged the entire world."

He drummed his fingertips on the arm of his chair. "At any rate, Erin, I went to see Mr. Caskie Royal, the CEO of the U.S. subsidiary of Schiffer Hartwin Pharmaceutical, located right down the road in Stone Bridge. He agreed to see me because he fancied I was some sort of big-wig professor from Yale."

"You are."

He tried to laugh, but only dredged up a small smile. "Disease is the great leveler, Erin. If you're facing death, nothing else exists-money, fame, power all cease to be important. As for Caskie Royal, he said he was sympathetic, then actually threw his hands in the air. Told me he was trying his best to solve the unexpected production line problems brought on by overenthusiastic expansion, was the way he put it." Dr. Kender lowered his eyes to his clasped hands. "As if any moron would believe that. I mean, a company wants to expand and it doesn't determine the effects of said expansion on its current production of drugs?

"It's a lie, of course. I'll admit it, I wanted to pull him out of his big executive chair and choke the life out of him.

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"There is another Schiffer Hartwin production laboratory for Culovort in Spain. Their PR folk came up with a new reason for aborting production-quality-control issues, they said, and even the possibility the production line might have been sabotaged. It will take them some time to ramp up production again, blah, blah, blah."

"What about the media?"

"The fact that a cancer drug isn't available isn't sexy enough for the national media to make a big issue of it, since there's a different drug on the market. The Wall Street Journal and The Washington Post reported on the shortage and Schiffer Hartwin's response, but that's it. No digging, no real questioning of the company, and those two newspapers usually take an interest in medicine."

Dr. Kender looked like he was at the end of his rope. There was anger in his gaunt face, but more than that, there was a sheen of hopelessness. He said on a sigh, "My dad, you never met him, Erin. He's old school, tough as nails, determined to take care of himself. We've discussed going on the oral cancer drug, but he's heard too many horror stories about the side effects, and he can't afford it in any case. If he's forced to go on it, he'll probably sell his house, and he's already told me there's no way he'll let me help. I've wanted to choke him for his misplaced pride, even though I completely understand it."




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