A cancer center says ‘no’ to an $11,000 treatment. Will others follow?

October 15, 2012

The United States spends $750 billion annually on health care that does not make us any healthier. The world's oldest private cancer center, Memorial Sloan-Kettering in New York City, announced Monday a surprising step to bring down that number. It will not offer patients a $11,000 per month cancer drug called Zaltrap.

Simply put, top executives do not believe the drug is worth the price tag. Here's Peter Bach, Leonard Saltz and Robert Wittes in Monday's New York Times

The drug, Zaltrap, has proved to be no better than a similar medicine we already have for advanced colorectal cancer, while its price — at $11,063 on average for a month of treatment — is more than twice as high.

In most industries something that offers no advantage over its competitors and yet sells for twice the price would never even get on the market. But that is not how things work for drugs.

Health care is not like most other industries. As the Sloan-Kettering officials note, Medicare is required to cover any FDA-approved drug without regard for price or efficacy. Doctors often cite pressure from patients, who want the latest treatment — even if it's not the greatest. Some worry about what it would mean for their practice if they simply turned down requests for a drug they don't think will help. 

The Sloan-Kettering executives think that the less expensive choice is also the right one for patients.

National cancer treatment guidelines say that a drug that costs half as much, Avastin, works equally as well as Zaltrap for advanced colorectal cancer. It also comes at a smaller cost to the patient. Bach, Saltz and Witties estimate that a privately insured individual " would have to pay more than $2,200 out of pocket for a month’s treatment with Zaltrap."

Sloan-Kettering knows this won't significantly bring down unnecessary health-care spending — more realistically, it will barely make a dent. Instead, they see it as "a step in the right direction — one of many we need to take."

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