Dispatch: One Step Ahead

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Some of the points in the editorial “The Avastin Mugging” in today’s Wall Street Journal might look familiar. They were made yesterday by ACSH trustee Dr. Henry Miller and ACSH's Jeff Stier in their LA Times op-ed. The WSJ piece addresses the undue influence that drug cost may have had on an FDA advisory panel’s recommendation the agency remove Avastin’s breast cancer indication:

The decision betrays a bias that puts costs above treatment, and unless the FDA leadership overrules its own experts, the 40,000 women killed by breast cancer each year will be denied an important clinical option.

Stier points out that “there is a benefit to having drugs that are only marginally effective, so long as they are safe. Cost should not be part of the equation. Advances in cancer prevention often arise gradually thanks to novel medications with marginal benefits.” He adds, “Blockbusters come as a result of this built-up knowledge. Opposition to expensive and marginally effective drugs could have the unintended consequence of stifling innovation.”

ACSH's Dr. Gilbert Ross agrees with most of Stier’s analysis. “If Avastin were free, neither ACSH nor the FDA would be having this discussion,” Dr. Ross says, adding: “Even though the total benefit of Avastin for late-stage breast cancer patients was small, there are sub-populations likely to obtain greater benefit from Avastin than the population as a whole, and the FDA should take this point into account when conducting a risk-benefit analysis.”