Welcome to the new medical paradigm, the shadow of what  is yet to come. The tip of the iceberg is now exposed, with more unsettling revelations sure to follow:

The most salient point of this New York Times article from October 14, 2012 is not what it would like for us to infer (that Memorial Sloan Kettering Hospital has decided not to prescribe Zaltrap to its patients as a way to contain the escalating costs of medical care) but what it tells us so casually:

1. Two of the MSK doctors who urged this position have a paid relationship with Genentech, the makers of the allegedly less expensive drug (Avastin) which is a direct competitor with Zaltrap.

2. The authors of this article imply that  the main difference between Avastin and Zaltrap is the relative cost and that this decision to not prescribe Zaltrap has little negative impact on colon cancer patients. However, as a current ColonClub member who is actually taking Zaltrap points out, there is a potentially significant difference between the two: Avastin targets only one tumor growth receptor, whereas Zaltrap targets three.

How significant that difference is and whether targeting two additional receptors justifes the substantially higher cost remains to be seen. What is more troubling is that the authors, who have business ties  with the manufacturer of the competing drug have glossed over this difference altogether.

2. The FDA evaluates new drugs only on safety, with no consideration of cost effectiveness. Physician guideline- setting organizations rarely consider cost to the consumer in their decision process.

3. Once a cancer drug is approved by the FDA, Medicare is required by law to cover that drug. This sounds reasonable and fair,  until we learn that a 2003 law requires that Medicare  must pay whatever price the drug manufacturer sets — plus a 6% cushion (!!)

4. Both of the exorbitantly-priced drugs in question, Zaltrap and Avastin, offer a mere median 1.4 additional month of life  when compared with standard chemotherapy alone. And this at a cost of $5000-$35,000 per month, with a percentage of that cost paid by the patient him/herself.

Is it any wonder that out healthcare system is increasingly described as unsustainable?


About surfingon

I live in Hawaii. I surf in the winter and swim in the summer. I have been a hospice volunteer with a contemplative-care oriented hospice for 25 years have been part of their team that trains new volunteers for the last 9 years. I have walked the colon cancer path with my beloved husband these past 5 years. He died very peacefully in April 2009. I now seek to share what we learned, to shed light on the many dark corners of this often mystifying, heartbreaking and heart-opening journey.
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