Monday, December 7, 2009

The Price of Futile Hope.

I'm a couple days late on this article from the New York Times on the price of drugs with low efficacy rates. When a patient is dying of a disease that doctor's can't cure, they are encouraged to "not go gentle," to "fight to the end," to "pursue every possible option."

Decades of this has given us an environment where some will protest not having access to drugs that statistically have little chance of curing the disease, say less than 5%. But that chance is what some patients are encouraged by large drug companies and their (sometimes endorsed) doctors to take. It is a sad state that medicine is now in the business of fleecing dying patients in the name of false hope.

But the medical profession would much rather treat disease than prepare a patient for imminent death. We all tells our friends in crisis that everything will be "just fine." The truth is that there is no cure for death, not even a $65k a year drug.


A newly approved chemotherapy drug will cost about $30,000 a month, a sign that the prices of cancer medicines are continuing to rise despite growing concern about health care costs.

Fred R. Conrad/The New York Times

Preparing an anticancer drug. Many oncologists question the value of expensive anticancer drugs that can cost $30,000 a month but do not prolong life more than a few months.

Related

The Development of a Cancer Drug(December 5, 2009)

Minh Uong/The New York Times

The price of the new drug, called Folotyn, is at least triple that of other drugs that critics have said are too expensive for the benefits they offer to patients. The colon cancer drugErbitux, for instance, costs $10,000 a month and the drug Avastin about $8,800 when used to treat lung cancer. The price of Folotyn “seems way higher than I heard of before,” Robert L. Erwin, president of the Marti Nelson Cancer Foundation, a patient advocacy group. “I can’t imagine there not being a backlash against the pricing.”

Drug makers in general have been raising prices sharply in advance of the possible passage of health care overhaul legislation, according to various studies. But the price of cancer drugs has been an issue for several years.

Critics, including many oncologists, say that patients and the health system cannot afford to pay huge prices for drugs that, on average, provide only a few extra months of life at best.

And Folotyn has not even been shown to prolong lives — only to shrink tumors. The drug was approved by the Food and Drug Administration in late September as a treatment for peripheral T-cell lymphoma, a rare and usually aggressive blood cancer that strikes an estimated 5,600 Americans each year. It is available for sale, but its manufacturer, Allos Therapeutics, does not plan to start actively promoting it until January.

Allos defends the price, saying it made a significant investment to develop the first approved drug for this type of cancer.

“It’s a very aggressive disease, and patients right now have no options,” said James V. Caruso, the chief commercial officer for Allos, a 17-year-old publicly traded company based in Westminster, Colo., that has no other drugs on the market.

Mr. Caruso also said the price of Folotyn was not out of line with that of other drugs for rare cancers. Patients, moreover, are likely to use the drug for only a couple of months because the tumor worsens so quickly, he said. So the total cost of using Folotyn will be less than for many other drugs with lower monthly prices.

“We believe we are fairly priced,” he added, “and we’re benchmarked” against other drugs. In a conference call with analysts last month, Mr. Caruso said Allos had “not had pushback of any type at this point” from insurers.

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