A Tale of Two Drugs and Health Care Rationing

Drug A is approved by the Food and Drug Administration to treat a disease.

Drug B is not.

Drug A is proven effective to treat a serious disease.

Drug B is not.

Drug A is proven safe.

When Drug B is taken scientists report a higher rate of “serious systematic events” when it is taken.

If you are a government bureaucrat which drug do you recommend a patient take?

If you are an Obama ideologue driven by a desire to limit the cost of health care, you choose Drug B.

This is not a theoretical example but is the new reality of “comparative effectiveness,” a cornerstone of the president’s health care initative where cost trumps everything. The cheaper the cost, the more the government will push a drug despite safety consquences.

In the example above, Drug A is Lucentis and Drug B is Avastin. Lucentis is approved by the FDA that effectively treats wet age related macular degeneration, (“wet AMD”) a disease that causes blindness. Avastin is approved by the FDA to treat cancer, not wet-AMD.

The National Institutes for Health (NIH) has undertaken a study to determine whether Avastin can be substituted for Lucentis for eye injections – although it was never approved by the FDA for such a purpose. Even before the study was released, the FDA leaked some results of their study proudly proclaiming that the two drugs were equally effective in treating the disease. But Avastin, when used for this purpose, caused “serious systematic events” such as increased hospitalizations.

Lucentis is expensive and by comparison Avastin is not. With safety taking a back seat, bureaucrats could require doctors to substitute Avastin for Lucentis, a move that would save the government and insurance companies money, bending the cost curve, as the president says.

The president and his team are looking at health care backasswards. Cures should take precedence over rationing and cost savings. In a free market, innovators and inventors are rewarded for finding cures. Under ObamaCare, they are punished as the government directs consumers to cheaper, and less effective alternatives in order to save the government resources. In the long run, research dollars and investment will dry up as the return on investment dissipates. It takes billions to bring a drug to market. Who will take the risk if the government removes the reward?