Cancer drug rationing

In Brit officials wrestle with cost of cancer drugs AP/Forbes describes the UK experience with restricting public payment for expensive cancer drugs. It describes the experience with Sutent, a pricey product that extends life but isn’t curative. In the UK, that product is now available under NHS coverage, but originally it was deemed too expensive.

In changing course earlier this year, the institute decided that expensive treatments like Sutent would be approved under certain conditions: Such drugs had to extend life by at least three months and be used for illnesses that affect fewer than 7,000 new patients a year. That means the government is willing to pay to extend lives of those suffering from some rare diseases, but not for more common ones. That criterion offers a built-in protection for the government’s limited health budget.

One of NICE’s most contentious criteria is how much should be paid per each added year of a patient’s survival. The general threshold calls for not spending more than 30,000 pounds ($44,235) per year of life.

As the articles describes, Sutent and other expensive, life-extending drugs are widely covered in the US. With cost pressures, there’s a chance that the US will trend more toward the UK approach.

On the other hand, things may even be trending in the opposite direction in the US. A brain tumor specialist really expressed his concern to me about the impending approval of expensive new drugs that don’t extend life, but simply improve quality of life. I think this is the type of example where we’ll first see serious engagement in the US about rationing.

April 9, 2009

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