Avastin for Breast Cancer: NCCN Cost/Efficacy Not Our Department

Value in medicine appear to be an oxymoron. Despite having little evidence of efficacy but strong evidence of great cost, the National Comprehensive Cancer Network (NCCN) an ad hoc outfit that provides guidelines for cancer treatment has decided that Avastin should be available to treat cancer patients.

Apparently $80,000-$90,000 for treatment, for the drug alone, does not make them pause even a second on their recommendation.

Of course a significant number of the panel members who decided this, including the chairman are on Genentech/Roche’s payroll. (FYI Genentech/Roche makes Avastin)

The organization’s “quote” conflict of interest rules state:

Per NCCN policy (also on the website), disclosure of a relationship with an external party does not automatically disqualify an individual from committee membership.

The policy also states that committee members who have a “significant and direct or indirect interest with an external entity which constitutes a conflicting interest shall not participant in the NCCN Guidelines Panel’s discussion when the NCCN Guidelines Panel’s action or topic under discussion may advantage or disadvantage an external entity.”

However, the NCCN disclosure policy gives committee chairs discretion to allow panelists with potential conflicts to “participate for the purpose of providing or presenting information to the NCCN Guidelines Panel.”

Medicynical Note: Cost-efficacy doesn’t appear to be anyone’s responsibility. No wonder our non-system of health care is the most expensive by far in the world.

And no wonder our dysfunctional pathetic political non-system which oversees health care (as well as our national budget and debt “ceiling”) is the laughing stock of the world.


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