March 4, 2006

The fleecing of cancer patients

I don’t often criticize the pharmaceutical industry, because I am a capitalist at heart, and there are enough other, often ill-informed people out there to do it for me. I don’t begrudge the pharmaceutical industry its high prices on patent medicines. I do think that some of their practices are a little over the top. On the other hand, some of the major players in Big Pharma are considered some of the world’s most ethical companies.

Imagine my dismay, then, when I came across an article that I’d printed out from the New York Times back on February 15 about Avastin, a drug from Genentech that shows significant effect in terminal cancer patients suffering from colon cancer as well as late-stage breast and lung cancer. Avastin will cost upwards of $100,000 a year for treatment. While most patients that take Avastin won’t last a year, that breaks down to over $8,000 a month. (The average colon cancer patient on Avastin takes it for 11 months.) Naturally, insurance companies are reluctant to pay for the medication, and one can hardly blame them. (Contrary to popular belief, most insurance companies are not minting money.)

$8,000 a month.

What makes this price exorbitant even by my standards is how the price is justified. While there are drugs out there that are more expensive than Avastin, most of those drugs are for niche diseases which afflict only a handful of people. Avastin, on the other hand can be used for thousands of patients. Traditionally the high price of patent medicines has been explained away by talk of R&D costs, which as I mentioned yesterday, average $500 million per New Chemical Entity (NCE) regardless of whether that NCE actually makes it to market or not. Genentech, however, has justified their high price by citing the inherent value of life-sustaining therapies. That is, they’re using a patient’s desire to stay alive to justify the high cost of their drugs.

This, in my opinion, has crossed the line from being ethical to simple profiteering. Some patients aren’t taking other, similar medications because they can’t afford to, or because the benefits don’t outweigh the costs: Avastin and Tarceva (another cancer drug) cure cancer. They simply prolong life.

But Dr. Desmond-Hellmann, the Genentech product development chief, said she would recommend that Mr. Minrath be treated with Tarceva. “I don’t think any patient should go without a Genentech drug for an inability to pay,” she said. “If this is about money, that would disturb me.”

Because it only costs a fraction of what Genentech charges to manufacture Avastin, many doctors expected the price of Avastin to come down if (more like when) the drug is approved for lung and breast cancer, where doses can be as much as doubled compared to colorectal treatments. Dr. Desmond-Hellmann had this to say:

“We don’t actually know whether physicians will actually use Avastin as was used in the clinical trials,” she said.

Be disturbed, doctor. Take the blinders off and look around you and see what’s going on here. It’s called fleecing.

[tags]Avastin, bevacizumab, Tarceva, pharmaceutical companies, Genentech[/tags]

| 6:58 am |

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