Who Gets Expensive Cancer Drugs? A Tale Of Two Nations
The well-worn notion that patients in the United States have unfettered access to the most expensive cancer drugs while the United Kingdom’s nationalized health care system regularly denies access to some high-cost treatments needs rethinking, a team of bioethicists and health policy experts says in a report out today.
Delving into the question of expensive cancer drugs and who gets them, the team, led by Ruth R. Faden, Ph.D., director of the Johns Hopkins Berman Institute for Bioethics, found both systems are far from perfect and both drew them into a hot-button issue of the current U.S. health care reform debate: rationing.
Critics of the U.K. system say care there is rationed – that patients are denied some expensive therapies so that better health care can be provided to the nation as a whole. Critics of the U.S. system say care is rationed here, too – that only those with the very best insurance and those who can afford sky-high out-of-pocket expenses have meaningful access to any and all high-priced therapies, especially at the end of life.
The authors found that with regard to very expensive cancer drugs, both characterizations are largely correct. “The issue is not whether rationing is a good thing or a bad thing,” Faden says. “The issue is what we should do about extraordinarily expensive treatments, some of which do very little to improve how well or how long people live.” At the same time, she adds, “there is no ethically defensible reason why some Americans have access to expensive cancer drugs and some do not.” Read more
A Crystal Ball For Brain Cancer?
Bronnie McNabb, 57, considers himself lucky. When his aggressive brain cancer returned after chemotherapy and radiation last winter, his UCLA doctor prescribed the off-label use of Avastin, a drug shown to quell cancers in the breast, colon and lung.
One month later, McNabb’s tumors had shrunk by 95 percent. Subsequent brain scans show no trace of his cancer at all. The former marathon runner, ordained minister and father of two says he hasn’t felt this good since his diagnosis last winter.
In welcome news for patients like McNabb, the U.S. Food and Drug Administration approved the use of Avastin last month for the treatment of brain cancer. The powerful drug shrinks tumors by choking off their blood supply. Half of patients don’t respond to the therapy, though, exposing them to unnecessary side effects and medication costing up to $10,000 per month.
Now UCLA scientists have uncovered a new way to image tumors and forecast which patients, like McNabb, are most likely to benefit from Avastin before starting a single dose of treatment. The findings are published in this month’s issue of the journal Radiology. Read more