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Veteran Advisor

The Era Of Health Care Rationing Begins

Supporters of health reform said it would never happen. Maybe they got caught up in their own rhetoric. Maybe they just didn't want to believe it was possible. But rationing in America has started.

This week, the Food and Drug Administration is expected to revoke approval of the drug Avastin for the treatment of advanced breast cancer. Louisiana Republican Sen. David Vitter has described the anticipated move as "the beginning of a slippery slope leading to more and more rationing under the government takeover of health care."

It seems that even loyal Democrats have noticed the Obama administration's not-so-subtle policy shift toward rationing. According to Politico, many of the 34 House Democrats who voted against the health reform bill are aggressively touting their "no" votes in campaign ads.

The FDA claims its decision won't be based on cost, but Avastin isn't cheap — a full regimen costs about $100,000 a year.

Jean Grem of the FDA's Oncology Drug Advisory Committee was cited in the Wall Street Journal explaining why she voted to deprive breast-cancer patients of Avastin: "We aren't supposed to talk about cost, but that's another issue."

Two years ago, the FDA approved Avastin for breast cancer on the condition that further research would show the drug extended life expectancy. Everyone expected the drug to maintain its approval. Avastin has proven to be a wonder drug for countless women with stage IV breast cancer, slowing the disease's progression and dramatically extending life.

But when no significant increase in "overall survivability" was reported this summer, an FDA advisory panel recommended that Avastin's approval be withdrawn. Top FDA officials must decide by Friday whether they will accept or reject the panel's counsel.

No cancer drug has ever been taken off the market based solely on "overall survivability." Traditionally, calculations of a drug's effectiveness have been based on tumor response and progression-free survival rates.

Here, Avastin is a miracle drug. In the manufacturer's critical phase III study, tumors shrank in nearly 50% of patients receiving the medicine. Patients who received Avastin in conjunction with chemotherapy lived nearly twice as long as would otherwise be expected without their disease worsening.

For some patients — known as "super-responders" — an Avastin regime translates into years of additional life.

If the FDA strips Avastin of its approval, it's likely that private insurers and Medicare would stop covering the medicine, effectively removing Avastin from the anti-breast cancer arsenal.

Government rationing doesn't stop at Avastin.

Medicare coverage for Provenge, a drug for advanced prostate cancer, is also in jeopardy. Like Avastin, Provenge is expensive. Created using a patient's own white blood cells, the drug costs $93,000. The FDA has already approved Provenge as safe and effective, yet Medicare officials are currently deciding whether it will pay for the medicine.

If officials decide Provenge isn't worth covering, it will mark the first time Medicare has refused to pay for an FDA-approved anti-cancer drug.

The outrage over the administration's campaign against expensive but effective drugs has not been muted. Major cancer advocacy groups like Susan G. Komen for the Cure and the Ovarian Cancer National Alliance have come out in strong support of both Avastin and Provenge.

It's terrifying to think that distant, faceless bureaucrats are now making Americans' health care decisions.

Welcome to Obama-Care.Smiley Sad

 

23 Replies
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Veteran Advisor

Re: Any Dem Regrets?

I wonder if there are many democrats who regret supporting this ZeroCare plan?

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Veteran Advisor

Re: Health Care Rationing or effective health care?

The "miracle drug" Avastin is apparently having trouble living up to it's billing.

"Approved for patients with advanced lung, colon or breast cancer, it cuts off tumors’ blood supply, an idea that has tantalized science for decades. And despite its price, which can reach $100,000 a year, Avastin has become one of the most popular cancer drugs in the world, with sales last year of about $3.5 billion, $2.3 billion of that in the United States.

But there is another side to Avastin. Studies show the drug prolongs life by only a few months, if that. And some newer studies suggest the drug might be less effective against cancer than the Food and Drug Administration had understood when the agency approved its uses."

http://www.nytimes.com/2008/07/06/health/06avastin.html?_r=1

so for $100,000/year you only get an extra few months.

Hope they did not buy a 1 year supply.

And you want to blame it on your president, shame on you!

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Senior Advisor

Re: Health Care Rationing or effective health care?

AAAAAAAh, but over time the price comes down, not any longer, unless you are able to persuade the death panel that it has merit. Advancement in medicine is about to come to a screeching halt.

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Senior Contributor

Re: Health Care Rationing or effective health care?

"So for $100,000/year you only get an extra few months."

 

One of the biggest expenses in U.S. health care is for treaatment of elderly people during their last last couple of months of life.  Old age and various medical problems have limited the time these folks have left here on earth no matter how much we spend on their health care yet we continue to spend large amounts of money on them because it is human nature to try and do everything possible for our loved ones. 

 

If we are truly going to try and control health care costs this topic will need to be addressed but I doubt any politician will have the guts to talk about it and especially now after claims of death panels and killing grandma.

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Advisor

Re: Any Dem Regrets?

The only surprise is that anyone believed there wouldn't be these types of cost controls.
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Senior Contributor

Re: Any Dem Regrets?

Without Medicare, which many Republicans (including Reagan) opposed many old people over 65 would have died much earlier than they did because of cost issues.

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Veteran Advisor

Re: Avastin, dag

You are so right dagwud.

I would never want to refuse a treatment that could make life longer or even to reduce the suffering at the end of a life but I think the story of Avastin is a little different.

If you read the link you will note the quote which you used  "So for $100,000/year you only get an extra few months." continues with the phrase "if that" .

The question of how much good or prolonging of life with Avastin is apparently still open and not as good as first published

Senior Advisor

Re: Health Care Rationing or effective health care?

It sounds outrageous, but as everyone knows many do not need that benefit or die before they need it. All of them think they paid for it over a life time of taxes and insurance premiums. How many dollars have you paid for health insurance and compare that to claims.

 

There is no disgrace in wanting to extend your life. Or you children wanting to extend their parents lives. MY dad died in about 15 minutes in 1980 and he didn't cost the taxpayers a dime. My mother returns from the hospital today age 95. I suppose they could have ignored her and not hospitalized her for observation. I think she paid for medicare and her supplement plus nursing home insurance. Now that she needs help, you think she should be denied. Interesting!

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Advisor

Re: Any Dem Regrets?

Collectivism is the reason medical care is so expensive.   Look into elective type procedures, quality and technology have improved while the cost has gone down.