My oldest childhood friend died of breast cancer. She lived am amazing 17 years after the initial diagnosis, and I am treasure every month. Josie had life-extending treatments that, I fear, would not be available under the administration’s new healthcare system.
My colleague Hadley Heath has already talked about the recent FDA decision on Avastin, a treatment for advanced breast cancer. The FDA has withdrawn its approval for Avastin. It is a harbinger of things to come when our healthcare decisions are made by bureaucrats rather than us and our doctors (and, yes, the insurance companies that are constantly attacked by the administration).
This FDA ruling should not be viewed as an isolated case of the agency’s nixing one expensive drug. A Wall Street Journal op-ed points out that decisions of this sort “may deplete the drug arsenal for terminally ill cancer patients.”
Avastin is an admittedly expensive drug that works by choking off a tumor’s blood supply and can extend lives. In individual cases, it has been known to give a patient the chance to see a child graduate from college, meet a new grandchild, or spend one more spring in the garden. For Josie and me, it was that last Christmas dinner in New Orleans.
But these are personal matters, not the sort of thing that a cost-cutting bureaucrat is likely to consider:
Patients did not live longer-that is, the overall survival rate did not improve in a statistically significant way. Yet a clinical trial showed a 52% median improvement in “progression-free survival,” which measures the time women live without their disease spreading or worsening. In practice, this means delaying the growth of tumors by about 11 months in combination with chemotherapy-five and a half months longer than chemo alone.
Metastatic breast cancers remain incurable, so the main goal is to improve quality of life: Oncologists try to control the spread of cancer and delay the onset of symptoms. Having more than one treatment choice is itself a real benefit for patients, minimizing psychological suffering and offering hope….
The Avastin mugging is really an attempt to undermine regulatory modernization like accelerated approval that offends the FDA’s institutional culture of control and delay. It is also meant to discourage innovations like Avastin that the political and medical left has decided are too costly, with damaging implications for the next generation of cancer drugs.
Given my experience with my old friend, this quote really got my goat:
One of [the board members] was Natalie Compagni Portis, a member of the original panel and amazingly enough its “patient representative.” She said, “Hope is very important. But to offer hope that isn’t substantiated I don’t think is responsible.” Jean Grem of the University of Nebraska explained her anti-Avastin vote by observing, “We aren’t supposed to talk about cost, but that’s another issue.”
Hope that is not “substantiated” sounds pretty cold, doesn’t it?
My friend had hope until the end, and hope is what gave Josie the will to struggle.