Wednesday, December 19, 2012

Does the cost justify the means?

According to a recent article in Medpage Today, an estimated 75,000 cases of melanoma are expected to be reported in the United States in 2012. Considering that melanoma has been tagged as the deadliest form of cancer, it should be no surprise that there is ongoing research to find a cure.

In 2011, a BRAF inhibitor called vemurafenib (marketed as zelboraf), was approved by the FDA after exhibiting significant increases in the survival rates of patients in the late stages of melanoma. Prior to zelboraf, dacarbazine was the only treatment available to those diagnosed with melanoma. However, the medication proved to be effective in only 7-12 percent of all cases. In addition to increasing a patient’s chance for survival, zelboraf has also been shown to improve a patient’s quality of life and self-sufficiency.

Unfortunately, while the statistics relating to zelboraf are promising, the cost for treatment is extremely discouraging. Angie King, a PharmD student at Northeastern University in Boston, has been conducting a budget impact study to determine if the cost of zelboraf justifies its use in Medicaid programs. 

According to King, conventional treatment with dacarbazine would cost $31,873 per year, whereas a year of treatment with the traditional drug plus vemurafenib could cost as much as $314,347. That is a startling difference, but refusing to offer this new treatment due to cost could raise major ethical questions.

Do you think that an expensive drug such as zelboraf should be made available through Medicaid if it saves lives?

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