A column by Peter Ubel at Forbes online talks about the high cost of Perjeta, a new treatment that can delay progression of metastatic breast cancer for up to six months, and asks: Is it worth it?
Perjeta (pertuzumab) is a HER2/neu receptor antagonist indicated in combination with Herceptin® (trastuzumab) and docetaxel for the treatment of patients with HER2-positive metastatic breast cancer who have not received prior anti-HER2 therapy or chemotherapy for metastatic disease.
And the NCCN just updated guidelines to include Perjeta as a "preferred first-line treatment for patients with HER2+ metastatic breast cancer (category 1)."
It works, but is it worth it?
It's worth it to the patient for sure, but with a price tag of $100,000 per patient (and that would be in addition to the $80,000 for one 18-month course of Herceptin) is the price just too high?
Ubel points out:
In the United Kingdom, new drugs like Perjeta have to be cost-effective before the National Health Service there will pay for them. The current cost-effectiveness cut-off is well below $200,000 per year of life. In other words, if patients in the UK want to receive Perjeta, they’re probably going to need to pay out of pocket.
Americans assume that if we have insurance, it should cover at least part of our treatment. And if we are on Medicaid/Medicare, then it will be completely covered. However, is that the wisest choice if it means higher premiums or taxes to cover the expenses?
I tend to agree with Ubel: It's time to make some difficult choices and set some limits. However, who gets to decide?
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