Looked at one way, Avastin, made by Genentech, is a wonder drug. Approved for patients with advanced lung, colon or breast cancer, it cuts off tumors’ blood supply, an idea that has tantalized science for decades. And despite its price, which can reach $100,000 a year, Avastin has become one of the most popular cancer drugs in the world, with sales last year of about $3.5 billion, $2.3 billion of that in the United States.
But there is another side to Avastin. Studies show the drug prolongs life by only a few months, if that. And some newer studies suggest the drug might be less effective against cancer than the Food and Drug Administration had understood when the agency approved its uses.
Like the CT Angiograms, the difficulty here is what costs should be paid to improve the quality of life of a terminally ill patient. While compassionate people may think that almost any cost is justifiable, one must recognize that from society's point of view, those dollars could be used to pay for TB drugs or for preventative care or for vaccines for children. As a society, America has seemed to strongly preferred costly tertiary interventions that benefit few patients versus more bland primary interventions that prevent disease across many individuals. Is this right? I am not sure, as ideally both ends of the spectrum would be covered, but I feel that we do tend to lean too far towards costly interventions on patients who may be better off with simply receiving palliative care. What do you think? Feel free to comment.
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