Amid growing controversy after several delays in making a decision, the Food and Drug Administration announced it would not approve of the use of the drug Avastin in the treatment of breast cancer.
Breast cancer groups mounted a significant public relations campaign in an effort to convince the FDA to approve the treatment in the wake of a June 2010 ruling by the FDA’s Oncologic Drugs Advisory Committee (ODAC) that the drug’s benefits were not sufficiently significant.
Says Decision’s Based on Costs
According to Sally Pipes, president of the Pacific Research Institute, the FDA’s decision is not based on the best outcome for patients but instead on the expense of Avastin, produced by Genentech, which can run as high as $90,000 per year for a single patient.
“The FDA claims its decision had nothing to do with Avastin’s cost and was based solely on the drug’s medical effectiveness,” Pipes said. “This isn’t believable. Every year about 40,000 American women die from breast cancer. Avastin is the last hope for many not to meet that fate. While the drug is costly, it often provides immense benefits to patients.”
Avastin works by cutting off blood flow to tumors, and it has been used by thousands of women to treat late-stage breast cancer. Pipes points out clinical studies have shown improved survival rates for women who use the drug.
“By restricting blood flow to tumors, the medicine can decelerate cancer growth. In one clinical trial, 52 percent of women saw their tumors stop expanding or spreading. Some have gained years of extended life.
“Most major cancer groups think that’s enough. Susan G. Komen and the Ovarian Cancer National Alliance urged the FDA to maintain approval of the drug, arguing that treatment choices should be left to patients and doctors—not a government agency,” Pipes added.
Start of Government Rationing?
According to Peter Pitts, president of the Center for Medicine in the Public Interest and a former associate commissioner of the FDA, the effect of the decision will be magnified as insurers take cues from the FDA.
“This decision will deny too many women the option to have their disease treated with a proven and effective therapy,” Pitts said. “Minus an FDA-approved indication, Avastin may still be prescribed by a physician, but it may very well not be reimbursed by a patient’s insurance. This is a bad day for the public health.”
According to Pipes, this may just be the beginning of rationing based on cost, thanks in part to President Obama’s health care law.
“The Obama administration hasn’t been shy about expressing its affections for the practice” of rationing, Pipes said. “None other than the head of the Centers for Medicare and Medicaid Services, Dr. Donald Berwick, has said that ‘it’s not a question of whether we will ration health care,’ but ‘whether we will ration with our eyes open.’ Government drug rationing isn’t going to stop at Avastin.”
Benjamin Domenech ([email protected]) is managing editor of Health Care News.