No such thing as Cost Effectiveness in U.S. medicine

Medicare has bowed to industry pressure and expanded the use of non FDA approved treatments for cancer. That means very expensive medications with little evidence of effectiveness will be used to treat cancers.

As noted in the article:

“One of the many drugs whose use is likely to expand is the Eli Lilly product Gemzar, which costs $2,500 to $5,000 a month. The F.D.A. has approved it to treat only four types of cancer. But the new rules will virtually guarantee that Medicare will pay for its use for about a dozen other cancers, including advanced cervical cancer – even though the evidence supporting Gemzar for that use is “inconclusive,” according to one of the reference guides Medicare will now be consulting.”

“Under the new rules, Avastin (medicynical note: one of the most expensive medication on the market at $10,000/month) will be routinely covered for ovarian cancer – as will at least some other off-label uses, including for brain and kidney cancer.”

“The new policy, which took effect in November, makes it much easier to get even questionable treatments paid for, critics of the changes say. Medicare is providing “carte blanche in treatment for cancers,” said Steven Findlay, a health policy analyst for Consumers Union. He said overly expansive coverage encourages doctors to use patients as guinea pigs for unproved therapies.”

Medicare has decided that cost effectiveness and value is not a consideration in cancer treatment. Without such analysis any system of health care is a goner.

We need a non-biased organization to review the effectiveness of medications. This evaluation would factor in such issues as whether the drug works for the indication, cost effectiveness and the value to the patient and health care system.

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