« BACK  |  PRINT

RS

FRONT PAGE CONTRIBUTOR

Obamacare worth 17.5K dead women a year?

Apparently.

By: Moe Lane (Diary)  |  August 16th, 2010 at 03:30 PM  | 

RESIZE: AAA

If you’ve missed the Avastin controversy, here’s a quick summary of it: Avastin is a general anti-cancer drug that got fast-tracked by the FDA a few years ago and is now prescribed to under 18 thousand women a year in the United States who suffer from the last stages of breast cancer.  It doesn’t cure the cancer; it has side effects; and its beneficial effects are disputed… but the drug has its defenders as well as its detractors.  However, now the FDA is contemplating reversing its approval of Avastin, which would probably mean the end of both its coverage by Medicare, and a subsidy program for low-income women.

Why?

Because then it won’t be covered by Medicare and the government can end the subsidy program for low-income women, of course.  The difficulty here for Obamacare supporters is that Avastin can cost up to $100K a year – the aforementioned subsidy program only covers about 40% of that, by the way – and under Obamacare the government would have to be the one to make the awkward and politically fraught call on whether or not to spend a lot of money making available a drug that doesn’t magically destroy cancer on the spot.  It’s another ‘take a pill‘ kind of situation, in other words: or to be even more inflammatory (but perfectly accurate), it’s another ‘death panel’ kind of situation.  There’s no good answer for an Obamacare enthusiast: if the drug’s available and you subsidize it, that’s up to a couple of billion dollars right there per year that the government will have to pay for a treatment of disputed efficacy (and demand for the drug will assuredly go up, if it’s subsidized).  If the drug’s available and you don’t subsidize it, you’re denying care under your system that was available previously (which is precisely what has been promised as not going to happen).  But if you can get the FDA to remove the approval, well… problem solved, right?

Assuming that you don’t have advanced breast cancer, of course.

Moe Lane

PS: Yes, I’m sure that the FDA will deny that cost considerations are what’s driving this possible reversal of approval.  Yes, certainly, of course they would have made the incredibly rare call of re-reviewing a fast-track drug if Avastin only cost $100/year.

PPS: The central fallacy of Obamacare is that it assumes that you can repeal the laws of supply and demand if you wish hard enough.  When it comes to socialized medicine… increased coverage, decreased costs, better service: pick one.

No, if you want to be able to pick two you need to go back to a market-driven solution.

Tags: ,

COMMENTS

POSTING RULES  |  LOGIN TO COMMENT  |  REGISTER TODAY
  • http://www.twitter.com/RS_yoyo yoyo

    You know, “The Land of Unicorns & Pixy Dust” they get all three sides of the Triangle. Only THEY get it.

    But, who else *REALLY* matters anyhow?

    As long as they get covered, for less and still can afford their personal doctor, who cares about us chattel?

    Come-On! You know better than to question The Won in his indefinite, oops, I meant “infinite”, wisdom… Heresy!

  • teapartyamerican

    “Federal regulators are considering taking the highly unusual step of rescinding approval of a drug that patients with advanced breast cancer turn to as a last-ditch hope.”

    Palin understated the horror – the feds won’t have “A” death panel – they’ll have MANY, MANY, MANY DEATH PANELS under obozocare.

  • K.

    For all the Democratic complaining about our health care system, this bill did nothing to address the most important way our system falls short when compared to other countries: its costs are too high. This health bill even slightly increases the amount spent. In 2020 we are now projected by the CBO to spend 20.9% of GDP on health care compared to 20.8% if we did nothing. Both of these figures are completely absurd amounts to be spending on one sector of your economy.

    But the concern of Democrats was never about lowering these costs. It was about redistributing income away from the people who earned it and creating big new groups that depend on Democrat-created programs. This bill was financed with taxes on the successful and on medical corporations. That’s the Democratic health plan: don’t solve our problems, just pass new taxes.

  • fpete13527

    Come on Moe, Obamacare has far more important goals than to save lives and better healthcare.

    Why would a quality drug that could make a positive difference for women, be supported under ObamaCare amidst the far more beneficial goals listed below?

    The following ObamaCare goals are far more important!!!!

    Expand death panels for the elderly
    Increase Alinsky CZARs and Bureaucracy
    Kill free market
    Decrease the quality of healthcare
    Expand the liberal trial attorney lobby
    Expand the Union lobby
    Expand the IRS
    Increase Planned Parenthood abortions by another 3000%
    Overwhelm and bankrupt the economy
    Expand student loans if you take Communist curriculum
    Expand Socialism further for Dems http://bit.ly/bkij92
    Desecrate the U.S. Constitution

    And….have the Lame Stream State Run Media spin all the above as great even when it is clear that Obamacare is an Obamination!

  • http://www.2010blog.net jsanzone

    An influential medical panel bumped the screening age from 40 to 50, and said that those 50+ should be tested less frequently for breast cancer. That was a few months before ObamaCare finally passed, if I remember correctly.

    Death panels are a reality, if not “panels” from the onset. The economic model is intrinsically a death panel, as Moe points out.

  • acat

    if you can’t shift the blame around between them so no one person is responsible?

    It’s not only a horrid government solution, it’s one that would be very difficult to Alinsky…

    (identify a target… was it this department? that one?…. I dunno, wanna go to the mall?…)

    Mew

  • lincolnrepub

    Post title is disingenuous, at best. This drug was on the fast track approval. Subsequent studies showed that it did not extend life or improve quality of life, while have a significant risk profile. Read on:

    The FDA approved Avastin under a special program designed to make new treatments available as quickly as possible, with the caveat that pharmaceutical companies conduct follow-up studies validating their drug?s effectiveness. The agency has been criticized for failing to adequately review such approvals. Only one of at least 90 drugs that have received accelerated approval has been pulled.

    An FDA advisory committee voted 12-1 July 20 to withdraw Avastin?s authorization for advanced breast cancer based on two new studies that the advisers concluded had failed to show the drug actually extends life.

    ?The vast majority opinion of the committee was that the drug was not doing very much, and what it was doing was more than offset by the negative,?? said Wyndham Wilson of the National Cancer Institute, who chaired the committee. Avastin can cause a variety of potentially serious side effects, including blood clots, bleeding, and heart failure

  • mbecker908

    No matter what criticism you might level at this post, it is the parson’s wife compared to the whore that is ObamaCare.

    In addition, the point is that new drug development will be memory in nothing flat.

  • jisaacconnett

    The real issue in this case is not even Obamacare. The issue is whether of not there is any good reason for women with advanced stage cancer to take this very expensive drug.

    When I was in nursing school, I wrote a research paper on this issue, though not about this particular drug. In general, people who have metastasized cancer have a very poor prognosis. Extensive efforts to save or prolong life for these people usually end in failure. At the best, one might extend life expectancy by a few weeks. Taking drugs, doing chemotherapy and/or radiation therapy might enable one to live a few more weeks, but usually also make the person more sick and miserable for the duration of treatment.

    Surgery and chemotherapy is often successful when the cancer is detected prior to reaching metastasis, but the treatment for people in late stage cancer is usually hoping against hope and groping in darkness. The question of what to do about using drugs such as Avastin is not really a question about saving lives, nor is it a question about Obamacare. It is a question about fighting for that last faint hope until the inevitable end comes. There is probably no one correct answer.

  • johnconradarens

    Corporate Average Fuel Economy standards (-that is, CAFE) have accounted for nearly a half-million dead or mangled Americans since their adoption in 1977. The only way to increase fuel economy while keeping a vehicle affordable was to reduce its weight– which makes a lightweight car vulnerable to heavier ones. So, Liberalism is deadly.

    DDT has been banned since Rachael Carson declared it responsible for decimating the bluebird population, and millions of people (-a large majority being children) have died in the third world from malaria. So, Liberalism is deadly.

    Morton-Thiokol replaced the asbestos -based O-rings in the early shuttle Solid Rocket Boosters with “nonsbestos” o-rings, which failed, and killed 7 astronauts in 1986. Liberalism is deadly.

    Liberalism is deadly. Ah-yup. So, what are we prepared to do about it?

  • gazill

    but I do agree with you here. Avastin was granted an accelerated approval, which meant at the time, it showed benefit in PFS (Progression Free Survival), a surrogate for overall survival, but without complete data that supported an increase in survival. Usually, AA requires follow up trials to demonstrate a clinically meaningful benefit (or that there is no decrement in overall survival) in order to receive full approval; bev, unfortunately, did not show an increase in survival. In fact, if I recall, when bev was given in combo with paclitaxel versus paclitaxel alone, Taxol showed higher survival, with less toxicity. Bev is a highly toxic drug that has shown efficacy in, and is marketed in, other indications; metastatic breast is just not one of them.

  • taxpayer1234

    When Hillary tried to force socialized medicine on us in the early 90s, the pharma industry ran away screaming. Today, there are only a handful of pharma companies left in the US, and most of those have moved their facilities (and jobs) overseas.

    Worse, though, is what happened to the industry: It all but stopped innovating and fell back on making “me-too” drugs. Some companies (like Pfizer) stopped making drugs and turned into Merger & Acquisition entities.

    Biotech has (somewhat) stepped into the breach, but since Genentech (Avastin’s creator–coincidence?) is likely the only biotech company actually turning a profit, any more strangulation of the industry will cause venture capital to run for easier pickings, like Hollywood movies or something.

  • taxpayer1234

    that Avastin didn’t live up to its promising profile when it was approved on the fast track, but that was still not a good enough reason for the FDA to want to yank it. And having dealt with the FDA for over 20 years, he confirmed that cost is WAAAAAY OUTSIDE the FDA’s regulatory purview. He’s disgusted that the FDA is even considering cost because that’s a market issue, not a science issue. And I totally agree.

  • taxpayer1234

    to try or not try a drug. Good oncologists are straight up with their patients about the choices available, but the patient still has a choice. When my dad had esophageal cancer, he’d had several different chemo cocktails nearly constantly for 3 years. Each time the doc proposed a new treatment, my dad had the choice to take it or not. The doc suggested another chemo treatment during my dad’s last 6 months, and my dad decided against it.
    All the choices he had made it possible for him to live 3 good, quality years past his diagnosis. It wasn’t always easy, but it was entirely HIS choice–NOT an insurer’s.

    By denying one expensive cancer drug, and then another, and another, will take us down the slippery slope of taking away cancer patients’ choice altogether.

    Not only will the lack of choice squeeze the life out of our ill loved ones, but it will kill the market for cancer treatments. And that will put us farther away from finding a cure. Is that really where we want to go as a society–to give up on finding a cure for the nastiest disease on the planet?

  • littlehouse18

    to me there are few things more important than my family’s health, and yes, in our personal economy we have spent about 20% some years on medical expenses. It’s a priority for us. If the USA spends more than other countries, I can only say, you get what you pay for. In fact, my family’s health is so important to me that I do not want government controlling it.

    Now, I’m not against containing costs, and there are lots of reasons costs are so high, many of them due to government interference.

  • littlehouse18

    She’s been going on for a while now. Don’t know what she’s being treated with, though.

    It’s nobody’s business but the patient’s if they want to strive to continue.

  • littlehouse18
  • K.

    The truth is there’s really no reason for costs to be this high. Our life expectancy and infant mortality are certainly nothing to rave about. Our wait times to see a specialist are pretty good among industrialized nations, but not as good as Germany’s, and our times to see a general physician are on the low end.

    We can argue about good ways to drive costs down, but in this round our Congress didn’t address any of the big problems. All they did was tax people and spend the money in the same system. Not cool.

  • jisaacconnett

    Taxpayer1234, your point that the cost of Avastin is outside the FDA,s regulatory purview is well taken. Good point! What is within the regulatory purview of the FDA? It is the task of the FDA to ascertain if a drug is save and effective. So, is Avastin safe and effective? According to trials more recently run, it has a long list of complications and it also has some “black box warnings”. In other words it can, in a relatively small percentage of cases, cause devastating side effects. Is Avastin effective? There is no proof that it is effective in prolonging life. Those are relative good reasons for the FDA to second guess the wisdom of approving its use.

    To give those who chose to use Avastin as a treatment option the right to chose their own treatment plan, lets say, even though the drug is questionable as to safety and effectiveness, it should be made available on the market. The next question is, who should pay the cost? Should the taxpayers have to pay the cost of making the drug available for Medicare and Medicaid prescribed treatment? If tax payers should foot the bill, why should they? Just how much legalized theft of the taxpayer’s resources are we supposed to approve?

  • bk

    If it has shown to be effective with colon cancer and is approved for that, and if it’s not effective with breast cancer and so not approved for that, then that is how things should work right?

  • taxpayer1234

    private insurance to have that choice, but someone on Medicare does not?

  • jackhammer

    we all hear every day how much cost goes into the R&D of these drugs 8they forget to mention how much money goes into the marketing of these drugs (about 5x the cost of R&D)…but I can see the FDA holding drug companies ransom on approval or not depending on price…the temptation will definitely be there with a government run system…

    “well if the price was only $10,000/year THEN we might not take ti from the market… but of course you have the possibility of sticking with your price, and having us take it off the market….bye bye to all those R&D bucks….”

    But of course restaurants also really like doing business when they have to hand over a couple of grand a month to make sure no one smashes their windows or starts a dumpster fire….

  • davesinsanantonio

    private insurance anyway, so they don’t care about temporary inconsistencies. Actually, the Left never care about their inconsistencies. They only point out, or manufacture, supposed inconsistencies on the Right, Then they go merrily on their hypocritical way. If the end justifies the means, then only the end matters, not consistency. So, they can be “for the war before they are against the war”. And sometimes they can be both for and against something at the same time and call it “racist” if you disagree with them.

  • holystone

    The use of an expensive drug that prolongs life for a short period of time is a personal decision when you can pay for it. When that decision becomes the responsibility of the society at large, society has a right to have an opinion. Sometimes the only drug that makes sense is either pain control or termination. I will set you an analogy that many of us have experienced. I recently put down an animal that had been my boon companion for 16 years. He was a foundling that had I not intervened would have lived a short exciting brutal existence. We were friends. In his final six months of life his eye started to bulge out of his head. The vet said it was cancer and I could opt for an operation that would cost $2000.00 with no guarantees. The one thing we did know was that his recovery would be very uncomfortable and that he was currently in no pain. I chose to take him back home and let him live what he had left to live undisturbed. A week later he had a massive fit in the middle of the night. The, as I perceived it, horror in his eyes after it subsided was enough to convince me that his time had arrived. He went peacefully. Why is it that we can manage to treat our animals humanely but are not allowed to discuss this option openly for ourselves? When will we become rational about death? And before all of you start screaming about government death panels and sanctity of life, I would remind you that there is a right that exceeds all of your and society’s opinions and that is my personal decison with God’s help to determine when I will go home.

  • minncon

    OK, OK, that’s a bad joke. But it needed to be made.

  • acat
  • renny

    and the so-called commie curriculum:

    Supposedly, student loans will now be much harder to get for small, private for-profit colleges; AKA, Christian schools, particularly peppered throughout the South. You know the ones that still have dress codes, require Western Civ. as a core course, and don’t have Porno 101 as a freshman requirement.

    Almost as good as closing Rep.-owned car dealerships.

    Wherever one looks, the little o has a finger in the pie to hijack traditional America.

  • stephaniet

    …and then I felt really, really bad about it.

    Btw, minncon, I do so love the quote in your signature. A friend sent me that very clip of the movie once, and it was wonderful.

  • http://www.scragged.com petrarch

    Sounds like a dark-side mirror image of the Tea Party, actually – a bunch of interlocking groups that can switch off as required, with no particular one of them being absolutely critical or vital.

  • minncon

    I love that clip, too!

  • BA Cyclone

    But not a good one.

    The government has been meddling in the market, directly and indirectly since 1965.

    The issue is compounded by the reality that most “private” people purchase medical care via employer-plans.

    So the overwhelming majority of medical care choices are not made by the person actually paying the bill. Thus the natural power of price and therefore cost control is lost because the price of delivering the service is hidden from the user six ways to Sunday.

    Maybe I will be a customer that says, ‘just give me whatever, I don’t care the price’…but that should be a direct choice of you spending your own limited resources. If you are always spending “someone else’s money” then why should anyone care what the price is on the invoice?

    The systemic incentive to control costs is effectively zero, and this is primarily driven by government’s smothering hand in the market.

  • acat

    The book is called, IIRC, “The Blueprint”, and that’s *precisely* their method.

    Some days I think the reason we heard about Alinsky is because his tactics are “played” …

    Mew

  • BA Cyclone

    It should be a personal decision.

    If the government, or any third party is involved, it is not a personal decision.

    It should NEVER be the “responsibility of society at large.” This is insulting.

    The problem with Obamacare is it “fixes” the medical care system by taking all its weaknesses and empowering those exponentially. Society-power is doubled rather than halved. The model is central planning = efficient, just needs more centralization and more funding.

    Because you know, central planning of the market has worked so well so far. /sarcasm

  • K.

    …that you favor taxing employer health plans? This is a very appealing idea in many ways. However, it must also be admitted that our individual insurance market can be a wild place.

  • taxpayer1234

    1. You’re deciding for a dog. The dog can’t decide for himself.
    2. No one is telling you that you can’t decide your own fate. We’re all saying you have NO RIGHT to decide the fate of other humans.

    Only the patient knows what he wants to and can endure, and NO ONE should make that decision for the patient. My father had watched so many loved ones die of cancer that I thought for sure he’d choose the quick way out. But he didn’t. He chose the long road because he wanted to be with his family for as long as possible. We didn’t pressure him either way. He called all the shots, and we obeyed his wishes to the letter. And when he decided that he’d had enough, that was HIS decision, not ours.

    My father lived–and died–on HIS terms. That’s what FREEDOM is all about. To take away our choice takes away our freedom–even the freedom to end or refuse treatment.

    Any discussion of being “rational about death” has NOTHING to do with the one dying. It’s about not inconveniencing the living and invites supposedly “rational” solutions like death panels.

  • renny

    How many drugs and new med. procedures did the the USSR produce in 70 years or the Eastern commie bloc produce in 40 years or has Cuba produced in 50?

    Medicine will come to a crashing halt, just like cars in Cuba froze in 1960.

    It’s maybe one reason the behemoth will not get fully under steam. It’s just full of so many stupidities like charging vets for their protheses and therapy. It’s could be something out of the Twilght Zone. Da-da Da-da.

  • JSobieski

    In addition to R&D and marketing expenses, pharmaceutical companies also have to pay for expensive FDA testing. While there will always be some very smart and motivated people willing to spend their time in pursuit of cures, who in heck is going to invest money in their efforts to do so?

    We are the only country that allows for a free market return on drugs. In a sense, we subsidize the rest of the world. Within a generation, pharmaceutical companies will become overrun with the work ethic and drive that you find at the department of motor vehicles.

  • taxpayer1234

    drugs produced in the US, then the cost of drugs in the US would go down.

    The drug industry won’t become the DMV–it will do what other industries have done: Move out of the US. And in fact, it already has. There are only a handful of pharma companies based in the US.

  • JSobieski

    We have the research infrastructure here, and the PHDs won’t want to move to a place like Shanghai. Removing the profitability of the US market will however put a stop to most of the serious research.

  • taxpayer1234

    to follow the work in their specialty. And the newly-minted Ph.D.s won’t have much choice but to go overseas or not be able to pay off their student loans. The research infrastructure that USED to be here is fading away. Pfizer is a perfect example. In the past 10 years, it has bought 5 large companies (and a handful of small ones). Only ONE of those companies has a research facility left, and it’s only for animal medicine. Pfizer’s only human pharma research facility is in Groton, CT, and they’ve been laying off scientists on a fairly regular basis.

    The industry has been contracting since HillaryCare, and ObamaCare may be its death knell–UNLESS it gets repealed. I’m hoping against hope….

  • lineholder

    My mama died from breast cancer that metastasized to bone. The first evidence we had of that metastasis had taken place was when she went to turn a patient over in bed and her hip shattered. She had no insurance at the time. The attending physician told her that the kind of cancer she had was very aggressive and she might as well give up.

    A well-respected doctor in the community who had worked with mama for years got her to Duke University. They found out her cancer was estrogen-receptor positive and did a radical removal of all female organs. She went into remission.

    My family didn’t have the money for mama to have constructive surgery on her hip. She learned to live in a wheelchair.

    Mama was a devout Christian who loved being involved in church activities. She played the piano for a lot of different events. Not long after she broke her hip, they had Bible school for the kids at her church. There wasn’t a handicapped entrance into the church at that time, so every morning, mama had my daddy lift her out of the wheelchair and onto the bottom stair at the church. She would then push herself up the stairs, in extreme pain, silently crying the entire time. But once she got on that piano bench, she was filled with joy and gladness to be there and to contribute what she could.

    It was the quality of her days that mattered, not the number of them.