Thursday, August 19, 2010

The beginning of healthcare rationing.

A powerful editorial in The Wall Street Journal yesterday, describing the FDA's effort to withdraw approval of Avastin, an anti-breast cancer drug.   As the Journal notes, the Scarcitarian goal reaches beyond Avastin; the true goal seems to be to squelch all expensive medical R&D:

So here we have government-anointed medical patriarchs substituting their own subjective view of Avastin's risks and costs for the value that doctors and patients recognize. If Avastin is rescinded, thousands of dying women will lose more than proverbial false hope in the time they have left. They will lose a genuinely useful medicine.  . . . 

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.

Investigations at the frontiers of genomic science have only begun, and the learning curve for how subsets of patients respond to biologics, and how to target them, is steep. Yet the world's oncologists agree that the future of their science lies in patient-specific, biologic treatments. Cancer survival rates have improved gradually over the last several decades, thanks in part to improvements at the margin like Avastin.

After all, from the government's point of view, it's cheaper for people to die.   Of course, such a ruling is not only cruel, it is also short-sighted, because healthy and longer-lived people produce more for the overall economy.   And over time, drugs have a way of multiplying, and getting cheaper--that's the story of the whole industrial revolution over the last three centuries, and nothing about economies of scale will change in the industrial revolution's fourth century.  


  1. Jim:
    My understanding is that Avastin is a Colon cancer drug that they were trying out on Breast cancer. However, test stats showed life rate increasing by only one month.

    As you & WSJ cited: “the Scarcitarian goal reaches beyond Avastin; the true goal seems to be to squelch all expensive medical R&D.”

    On the other side of the see-saw, Doctors should stop using -abusing patients just to keep hospital bed occupancy high.

    I have seen a few instances where what the doctors did was uncalled for, playing on the heart strings of spouses.

    I’ve had 3 hip replacements; I’m 67. I blanched when I heard Zsa Zsa at 93 was going for a hip replacement. So, I turned to my wife and said don’t you ever let “them” do that to me. There comes a time when the circle of life must close. She agreed.

    Then I hear the doctors wanted to replace or cut out half of Gabor’s liver. I think they were nuts to make such a suggestion. The Gabor family had enough sense to say, enough is enough; and went home.

    There is need for some one or panel to say or have enough sense to say: “enough is enough;’ but, I don’t want it to be the Government.

  2. Its only going to get worse, much worse under Obama. Preferred parking for gays, gun seizures, church's closing, a mosque at Yankee Stadium, a Steven Segal comeback....its only the beginning for the hills while you still have time!

  3. The mere fact that they would do this to us is abominable of course, but it gets worse with time. Many new discoveries and treatments are very expensive in their early days. Remember when MRI and CAT scanners were extremely expensive? Remember when AIDS drugs were? If we can never do the research that would lead to new expensive treatments we will never end up with new cheap ones either.

    We have to repeal this mess as soon as it is feasible to do so!