When does a drug cost too much?
Recent approval of the drug Avastin by the FDA raises ethical and financial questions that we all need to consider. Avastin was recently given "accelerated approval" for treatment of advanced breast cancer on the basis of a single clinical trial that showed that when used with a second drug, it:
1. does not extend overall survival rates;
2. causes serious side effects, including a reported half-dozen deaths; and
3. holds tumor progression at bay for about 5 and 1/2 months.
The British National Health Service refuses to pay for Avastin for advanced breast cancer, citing the above limitations, and the cost: $92,000.00 per year, per patient. This is the kind of health care issue that should be discussed by our politicians and by all of us. What will we pay and what risks will we take, not to live longer, but to control our cancer better for six months? Are we willing to pay higher taxes or insurance premiums in order to afford this kind of expense? Are we willing to ration health care so it is available only to the wealthy? By refusing to consider and discuss these issues, that is precisely what we are doing.
We should note, too, that while Avastin is expensive, it is not unusually expensive: many drugs are priced comparably.