It begins: FDA may pull Avastin approval over cost concerns

I work off of facts, and the fact is Avastin’s efficacy is extremely suspect. If it cost was $10, I’d say who cares? But at $55K a pop, it we ought to be sure it works. That’s all.

rcpjr on August 16, 2010 at 1:12 PM

But I don’t believe this is the FDA’s job. The FDA determines if the drug is safe and works. Are they reviewing the drug to see whether it “works” 100% of the time? 20%? What is the acceptable level of working for FDA approval. Not all drugs work for all people. Some people are allergic to some drugs. Therefore, no drug can claim 100% effectiveness. the cost/benefit analysis is not FDA’s job.

As to the cost/benefit question, I see a lot of people writing on this site how we can’t put a value on a single day of life and nobody should be deprived this or any treatment.

I think we are falling into the trap of liberal thinking about insurance policies. We should not assume that every policy is going to cover every treatment. Insurers have to have the ability to deny treatments that have very little upside but that are incredibly expensive. If you want a policy that has no limit on potential treatments, you should pay a lot more in premiums.

Let us not forget that “health insurance” is not simply “pay all of my bills” – that is liberal thinking. Health insurance is supposed to be about risk sharing. That means at the end of the day the insurance company has hopefully spread the risk out such that it makes some money off of all the premiums after all the pay-outs. If we start thinking like liberals and demand that all insurance, including medicaid and medicare, cover every single treatment, regardless of any cost/benefit analysis, we are buying into the liberal fantasy that their is a free pot of money out there that will take care of all of our medical care needs.

For the system to work, some policies will cover X, some policies will cover Y, and some people will end up in situations where their coverage does not cover some really expensive or experimental treatment that they want or need. Of course, in our current system those individuals are free to obtain the money for such procedures / drugs through charity, etc.

However, if we cannot, as conservatives, accept those limitations on health care insurance coverage, than we may as well be for universal care b/c regulations mandating coverage of everything for everyone will surely put insurers all out of business leaving only the gov’t to turn to.

Monkeytoe on August 16, 2010 at 2:16 PM

First, thanks for being rational. At some point, there has to be a cost-benefit analysis completed, no? We can’t afford every and all treatments for everybodyu, even in the best of times. If this panels’ sole reason for ditching Avastin was cost, then I’m with you all 100%. However, not one but TWO new studies suggest Avastin has “no life-extending capabilities.” Given that, don’t we have to question whether it’s worth the cost? How many studies showing no results would convince you? 5? 10? 20? 2 is a pretty good indication that it doesn’t work, I think.

I don’t disagree if they are looking at the drug’s effectiveness. But in the article, they were specifically talking about cost/benefit – which is not the FDA’s job. The FDA is meant to note whether the drug is safe and whether it works. Now, as to what constitutes “works” in this context, I don’t know enough. As long as they define it the same way they define it for every other drug and do not take cost into account, then no problem with a review. Again, the cost is not FDA’s job, and using the FDA to disapprove a drug based on cost is simply a way to avoid the hard decisions that have to be made by Medicare, Medicaid, or various Insurance companies. If a drug is safe and saves the lives of 90% of people who took it, but cost $10 million a pop, the FDA should still approve the drug b/c it works and is safe. It is not FDA’s mission to debate the cost of the drug.

If Medicare came out and said that based on cost/benefit, they would not cover the drug, I would have no problem, as that is likely a rational decision.

Monkeytoe on August 16, 2010 at 2:24 PM

I think we are falling into the trap of liberal thinking about insurance policies. We should not assume that every policy is going to cover every treatment. Insurers have to have the ability to deny treatments that have very little upside but that are incredibly expensive. If you want a policy that has no limit on potential treatments, you should pay a lot more in premiums.

This is a completely different topic. You’re talking about an insurance company not paying for an available treatment. This story is about a drug being removed from the market by the FDA because its “too expensive”.

Whats next…the Mercedes 350SL? “It’s too expensive, therefore the government says no one can buy it”.

BobMbx on August 16, 2010 at 2:25 PM

If you read my whole comment, I agree that the cost/benefit analysis is not the FDA’s job. I would think that such analysis would be Medicare / Medicaid’s job in deciding what that covers – much like any insurer.

I was just commenting on the many comments that seemed to imply that there is a right to any treatment. I see far too many people, even here on the right, who confuse “health insurance” for some fantasy pot of money to pay any and all medical expenses with no cost/benefit analysis.

I agree that gov’t should not be making these decisions, and that Obamacare is a nightmare that will lead to the gov’t rationing ever more care.

But we have to remember that these cost/benefit decisions do have to be made. I want the free market to make them. Insurer X can offer a top of the line policy that covers every treatment under the sun, and people who can afford that can get it. Insurer Y offers more modest coverage, and some people purchase that. And so on.

And, as always happens, over time the new treatments become cheaper and the modest policies start to cover them. the free market works.

But there appears to be a general feeling, even on the right, that every policy should cover every experimental treatment/drug. That is simply not feasible. Some people, likely myself included, are simply going to have to go without the experimental / brand new treatments and drugs if we get sick b/c our policies don’t cover them.

Monkeytoe on August 16, 2010 at 2:35 PM