Bob Goldberg on the price-tag for survival …
It is both remarkable and tragic that at a time when we are finally winning the war against cancer, actually reducing the numbers of deaths due to that dreaded disease, the New York Times is editorializing against the value and use of the very medicines that have made such advances possible. Do we really need enemy combatants against medical progress?
The NYT claimed recently that Avastin at a retail price of $8000 for a month of treatment is too expensive for an average of 6 months of more life, without pain or toxic side effects for cancer patients that have not responded to other forms of cancer care. Here’s how I would have put the question: Is it worth having your insurance company pay about $5000 to keep you alive for 6 months or longer? What’s it worth to have drugs like Avastin around to keep tens of thousands of cancer patients alive longer and longer so they can live free of caregivers, can go to work, parent their kids, etc? The Times never asks that question.
Similarly, medical journals are now abandoning real science and are simply becoming collections of editorials by Monday morning quarterbacks. Most recent is the assault on the right of multiple sclerosis patients to use Tysabri to treat the devastating relapses associated with the disease. The British Medical Journal published “Lessons for Clinical Trials from Natalizumab in Multiple Sclerosis” by Abhlijt Chaudhuri, a physician known for believing that no drug for MS should be used without any rebuttal.
Unfortunately, his “lesson” seems to “grin and bear it.” Not acceptable.
The term ‘relapse’ sounds innocuous. It means losing balance, one’s sense of taste, eyesight, memory, etc. without warning. It can make walking impossible. The attack on Tysabri is simply an old saw applied to a new drug: since the drug doesn’t actually stop MS from progressing the possible long term safety problems aren’t worth the risk of returning to market. The article spews the same accusations made of every drug that is experimental: we don’t know what the optimal dose should be and how long people should take it. The fact that only clinical experience can help answer that question is ignored in favor of a standard of evidence that, if applied to the early release of penicillin, the measles vaccine, HIV drugs, and other breakthroughs, would have cost millions of lives.
That is like saying that since some drugs don’t cure a disease, don’t make them available at all. Again, the value of these medicines to people and their ability to give them back lives of productivity, dignity and independence means nothing.