Medicare Action Concerning the Overuse and Promotion of Dubious Drug Combinations for Cancer

February 17, 2009
Category: Uncategorized

Ralph Moss, PhD, author of the CancerDecision newsletter, has brought attention to a proposed change in Medicare rules regarding payment of anticancer drugs.
There has been much discussion in the Wall Street Journal and the New York Times regarding the FDA’s approval of a variety of new anticancer drugs over the past year. As Dr. Moss points out, they are at best “minimally effective. Sometimes, they confer a few months of extra survival; often times there is no proof they do even that. They also may carry an increased risk of serious side effects and in almost every case they are very expensive.” The newspaper articles have pointed out the extraordinary cost of these new anticancer drugs.
As Arthur Caplan, PhD, a bioethics professor at the University of Pennsylvania, said in the Wall Street Journal, “This is one of the toughest issues in oncology,” especially when drug prices can mean exchanging “family assets for the possibility of a few more months of life.” The New York Times article stated, “For many such uses there is scant clinical evidence that the drugs are effective, despite costing as much as $10,000 a month.”
We also need to keep in mind that doctors are not usually allowed to sell prescription drugs themselves, but cancer specialists can. This creates a financial incentive to use very expensive drugs.
Besides the effectiveness and cost issues of the new cancer drugs, Dr. Moss notes that Medicare has agreed to pay for a much wider degree of ‘off-label’ use” for new and existing cancer drugs. According to Dr. Moss, these off-label uses “are sanctioned by various guidelines called compendia that are often written with the eager input of drug company representatives.” Consider the example of Avastin. It will now be covered by Medicare for ovarian cancer. There have been no randomized clinical trials that Avastin actually increases the patient’s overall survival. Avastin is one of the most expensive newer drugs, priced at $100,000 per year.
Dr. Moss also wisely points out that the “double standard has just gotten much wider.” CAM (complementary and alternative medicine) treatments that have a considerable amount of data behind them still have little chance of Medicare reimbursement or FDA approval. Expensive randomized clinical trials are often out of the reach of CAM therapies, and now pharmaceutical drug makers, who can afford to do the clinical trials, have received a free pass.
Dr. Moss will present “Traveling for Treatment: Non-Conventional Cancer Therapies Around the World” at the March 11-15 International College of Integrative Medicine (ICIM) Conference. He will provide a comprehensive view of innovative cancer therapies in four countries.
AAHF has pointed out that the FDA protects entrenched medical monopolies which pay its bills and hire its employees. Medicare in turn is only allowed to pay for FDA approved treatments. We need complete reform, a thorough overhaul of every part of the FDA. The purpose of ReformFDA.org is to persuade the American public and Congress that a total reform of the FDA is absolutely necessary in order to rebuild the American healthcare system and make it once again the envy of the world. Visit www.ReformFDA.org to sign the petition and learn more.

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