Avastin: Great hope, or futile care?

Today’s Managing Health Care Costs Indicator is $7 billion

That’s the annual revenue that Genentech gets from sale of Avastin.

Avastin is the first of the anti-angiogenesis medications – which we all hoped based on mice studies would kill cancers by starving them of blood supply.  It works – but not nearly as well as we hoped. An early study suggested that the drug might prolong life in those with breast cancer, but subsequent studies have actually shown that the drug offers no benefits, but does come with severe and even life-threatening side effects.

The FDA advisory panel voted 6-0 to remove the breast cancer treatment indication from this drug, which costs $90,000 per year.  The drug remains on the market – and continues to be recommended for the treatment of other cancers.   CMS will continue to pay for the drug when prescribed for breast cancer despite the adverse evidence, as will just about all private insurers. Those that announce they will not pay for Avastin are subject to blizzards of emails and protests and appeals.

Here are two voices on this issue. The first, yesterday’s Wall Street Journal editorial:

…There's no denying that [The FDA decision] decision is an awful turn for anticancer progress and innovation, and especially for the women who may lose a treatment option in the time they have left to live.”

Here is an enormously expensive drug that largely doesn’t work, has serious side effects and can no longer be marketed as a breast cancer therapy. Yet insurers, including Medicare, will continue to cover it...If we’re not willing to say no to a drug like Avastin, then what drug will we say no to?

 We won’t solve the health care cost crisis if we continue to cover expensive, ineffective drugs.   It’s hard for me to see this as heavy –handed government overreach.  Forget about the cost –the medicine appears to make the lives of terminally ill women worse.  Giving physicians and patients the information they need to make the best decision seems like a good role for the FDA.