The High Cost of a Cancer Drug - New York Times

March 10, 2008

SNIP

The key

study showed that when used with another drug, Avastin almost doubled the time

cancers were held in check before starting to worsen. It also doubled the

number of women whose tumors shrank significantly.

It did

not extend overall survival rates and caused more serious side effects,

including perhaps half a dozen deaths. That seems like a modest basis for

approval pending completion of additional clinical trials. The quandary is

whether an extra 5 1/2 months of holding tumor progression at bay is worth

toxic side effects.

The drug

is already prescribed “off label” for some 11,000 American women

with advanced breast cancer, but the latest approval is expected to increase

its use among some 43,000 women deemed suitable candidates for treatment. The

cost could be enormous. Genentech charges about $92,000 a year for breast

cancer patients. For women with annual family incomes below about $100,000, it

caps the charges at $55,000 a year.

The

company argues that Avastin emerged from many years of costly research. It does

not claim that the drug is cost-effective for advanced breast cancer but

believes it will clearly be worth the cost if shown effective in earlier stages

of breast cancer.

Britain’s

National Health Service has balked at paying for Avastin for breast cancer

patients. If this country hopes to get escalating health care costs under

control, it will need a way to determine which treatments are worth paying for,

and which are not. The case of Avastin is a reminder of just how difficult that

can be.

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