Cost Matters: Colon Cancer, Zaltrap (ziv-afibercept)

Sounds crazy, a drug (Zaltrap) costing $11,000/month, with little efficacy is being actively promoted to desperate patients.  A classic case of any promise of efficacy, no matter how small, or how expensive, being irresistible to those with dread diseases. 

What’s even more amazing this article makes the righteous argument that another drug costing only (sic) $5000/month (Avastin)  offering similar (in-)efficacy should be used in it’s stead. 

The “benefit” of these super expensive drugs is roughly the same,  a miniscule 1.4 months median survival.

Medicynical Note:  It’s good that Sloan Kettering finally seems to recognize the folly of a minimally effective agent costing so much.  The benefits, by the way,  are truly minimal.  When a drug offers a median benefit of 1.4 months it means that half the people got less than that benefit (at $11,000/month).  True, half did better but the same could be said of the conventional regimen or placebo with which it’s compared. 

Does 1.4 months median benefit justify the expenditure of over $60,000/year (more than the median or average income of families in our country) on a single drug?  And this expense doesn’t include doctor’s fees, lab costs or imaging expenses. 

One response to “Cost Matters: Colon Cancer, Zaltrap (ziv-afibercept)

  1. Alvin L. Beers, Jr. MD

    Kudos to Drs. Bach, Saltz, and Wittes for their editorial in today’s NY Times “In Cancer Care, Cost Matters”. Memorial Sloan Kettering Cancer Center has decided to exclude Zaltrap from their formulary. Runaway cancer drug prices constitute a significant portion of our nation’s health bill. Medicare regulations do not allow changing coverage based on cost comparisons when 2 drugs work equally well with similiar side effects (as is the case for Zaltrap compared to Avastin). So Memorial has done what others will not do, usually for political reasons. This kind of cost comparison, by the way, is not difficult to obtain if one remains honest and open regarding the data utilized to compare.

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