New York magazine has an extensive article of the cost of new cancer drugs. The example they use is Zaltrap, which the FDA approved for treatment of advanced colon cancer, for patients in whom more standard treatments have failed. Studies show that several months of treatment with Zaltrap can extend a patient's survival for an average of 42 days. The cost is $11,000 a month. That is only for the drug itself; it does not include the cost of administering it intravenously, the cost of hospitalization, or the cost of drugs to combat side effects. The effectiveness of Zaltrap is equivalent to Avastin, another drug of last resort, which costs half as much.
The FDA cannot take cost into consideration when it approves new drugs -only safety and effectiveness. When doctors take cost into consideration when prescribing treatment for their patients, they are lambasted for being cold-hearted. And it is extremely difficult for families to weigh cost-effectiveness when confronted with a dying loved one. But is extending the life of a terminal patient for six weeks of bedridden illness worth bankrupting the family -or our health care system? Gastrointestinal oncologist Leonard Saltz of Memorial Sloan-Kettering Cancer Center says the time has come in which we have to consider such questions.
“There is a number in people’s minds,” he says. “If you say to people, ‘I have a drug that extends life by one day at a billion dollars; shouldn’t we as a society pay for it?,’ I’m pretty confident most people would say no. If I say, ‘I have a drug that extends life by three years at a cost of $1.50,’ I’m pretty confident everybody would say, ‘Of course!’ Somewhere in there is a number, a tipping point, where we say, ‘No, we can’t.’ Right now, we’re unwilling as a society to explore where that point is. And I would argue that we have to. Wherever it may be, we have to find it.”
The pharmaceutical industry defends its pricing by citing the enormous cost of bringing a new drug to the market. But if the newest drugs for cancer provide so little benefit, wouldn't that research money be better spent to develop new vaccines or antibiotics or drugs that benefit a larger number of patients? Maybe, but terminal cancer patients are more willing to agree to extremely expensive treatments. There's a lot of food for thought in the article by Stephen S. Hall. -via Metafilter
(Image credit: Remie Geoffroi)