Monday, July 26, 2010

Business, public service, or extortion racket?

There's an editorial in the Times this morning about a breast cancer drug for which the FDA wants to withdraw approval. Avastin(tm) was approved some time ago on an accelerated schedule, because it's only approved for people with advanced cancers (why hold back approval for a drug that may be the only hope of people who otherwise have no hope?) While Avastin has the benefit of slowing cancer growth, it's finally been shown in new studies to have no effect on extending life.

Buried in the story, however, is this curious paragraph:
The cost of Avastin has always seemed outrageously high for the medical benefits it confers. The wholesale price for a typical breast cancer patient is about $88,000 a year. Genentech has been capping annual spending at $57,000 for patients with incomes below $100,000.
It appears this wonder drug has the almost miraculous effect of transfusing all of the stricken patient's assets, (and their remaining insurance benefits), into the coffers of the drug company right at the end of the patient's life, when no one's quibbling with the fine point of grand larceny.

And the company that produces and sells the drug, Genentech, prices the treatment differently depending on the patient! So it costs between $57,000 and $88,000 per year, depending on the patient's income. This simple income redistribution mechanism (all of a dying patient's assets are redistributed to Genentech) manages to maintain the facade of a nice clean capitalist sale of a product for a price. In order to determine whether Genentech's Avastin is the appropriate treatment, they need to know precisely the type of cancer you have-- the lab work-- as well as your 1040 forms to determine your precise levels of illness and income.

This is vile! This is corrupt! This is a glimpse at an ugly facet of capitalism that is rarely discussed. Fie on the whole system that allows this to happen.

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