If you’ve missed the Avastin controversy, here’s a quick summary of it: Avastin is a general anti-cancer drug that got fast-tracked by the FDA a few years ago and is now prescribed to under 18 thousand women a year in the United States who suffer from the last stages of breast cancer.  It doesn’t cure the cancer; it has side effects; and its beneficial effects are disputed… but the drug has its defenders as well as its detractors.  However, now the FDA is contemplating reversing its approval of Avastin, which would probably mean the end of both its coverage by Medicare, and a subsidy program for low-income women.

Why?

Because then it won’t be covered by Medicare and the government can end the subsidy program for low-income women, of course.  The difficulty here for Obamacare supporters is that Avastin can cost up to $100K a year – the aforementioned subsidy program only covers about 40% of that, by the way – and under Obamacare the government would have to be the one to make the awkward and politically fraught call on whether or not to spend a lot of money making available a drug that doesn’t magically destroy cancer on the spot.  It’s another ‘take a pill‘ kind of situation, in other words: or to be even more inflammatory (but perfectly accurate), it’s another ‘death panel’ kind of situation.  There’s no good answer for an Obamacare enthusiast: if the drug’s available and you subsidize it, that’s up to a couple of billion dollars right there per year that the government will have to pay for a treatment of disputed efficacy (and demand for the drug will assuredly go up, if it’s subsidized).  If the drug’s available and you don’t subsidize it, you’re denying care under your system that was available previously (which is precisely what has been promised as not going to happen).  But if you can get the FDA to remove the approval, well… problem solved, right?

Assuming that you don’t have advanced breast cancer, of course.

Moe Lane

PS: Yes, I’m sure that the FDA will deny that cost considerations are what’s driving this possible reversal of approval.  Yes, certainly, of course they would have made the incredibly rare call of re-reviewing a fast-track drug if Avastin only cost $100/year.

PPS: The central fallacy of Obamacare is that it assumes that you can repeal the laws of supply and demand if you wish hard enough.  When it comes to socialized medicine… increased coverage, decreased costs, better service: pick one.

No, if you want to be able to pick two you need to go back to a market-driven solution.