Will rationing supercede America s healthcare legacy?

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Is the U.S. moving towards health care rationing? Taking note of the U.S. FDA s plan to remove Avastin s breast cancer indication pending an appeal by the drugs manufacturer, Genentech, ACSH s Dr. Gilbert Ross warns against the FDA trend towards using treatment cost as a factor in the drug approval process in an op-ed published in yesterday s Medical News Today. Meanwhile, the U.K. is beginning to remove cost from its list of regulatory considerations. Avastin, a biological agent currently approved to treat lung, colon, kidney and one form of brain cancer, is one of the only viable treatment options available for women suffering from advanced-stage triple negative breast cancer the most difficult to treat form of the cancer but it comes with a heavy price tag without insurance coverage. Off-label drug prescriptions those given to treat conditions not approved by the FDA, such as breast cancer in the pending case of Avastin are much less likely to be covered by private insurance, Medicare or Medicaid, creating a heavy financial burden for patients who have not responded to FDA-approved treatments.

Rescinding the use of a medication because of its high cost looks a lot like rationing. The FDA doesn't want us to put it in those words, though - because it knows its decision would be even more unpopular than it already is. At least the UK's National Institute for Health and Clinical Excellence (the ironically named NICE) is honest about its work. It has denied the British access to Avastin and other life-extending cancer drugs and admitted flat out that it's because they cost too much. The new U. K. health minister has made it a top priority to stop NICE from rationing. But the FDA looks to be on the road to becoming a de facto rationer.

We have long prided ourselves on the choices and opportunities our healthcare system offered all Americans, especially those among us who are not able-bodied and well-heeled. We must not turn our back on that legacy. Patient advocates - and those fighting on behalf of women with breast cancer - hope the FDA realizes its mistake and gives choice and hope back to the thousands of women who don't have much of it left.