I think we may see more of these types of studies and the two doctors do state they have been paid consulting fees from Genentech (Roche) who makes Avastin. Avastin has been around a long time and it is not cheap either with an estimate of $5000 a month, but take on Zaltrap at double that cost? Cancer drugs and chemotherapy treatments are all over the map as far as cost. For Medicare patients, the out of pocket cost would be $2200 for Zaltrap. This will be interesting to watch to see if Zaltrap is somewhat forced to take another look at their pricing. I’m sure they will also want to see the exact results of the study. We could also see other cancer centers perhaps looking at the same thing to help substantiate the decisions made. BD
AT Memorial Sloan-Kettering Cancer Center, we recently made a decision that should have been a no-brainer: we are not going to give a phenomenally expensive new cancer drug to our patients.
The reasons are simple: The drug, Zaltrap, has proved to be no better than a similar medicine we already have for advanced colorectal cancer, while its price — at $11,063 on average for a month of treatment — is more than twice as high.
Which brings us back to our decision on Zaltrap. In patients with advancing, metastatic colorectal cancer, the new drug, approved by the F.D.A. in August and jointly marketed by Sanofi and Regeneron, offers the same survival benefit as Genentech’s Avastin, which works through a similar molecular mechanism. When compared with the standard chemotherapy regimen alone, adding either medicine has been shown to prolong patient lives by a median of 1.4 months. Major clinical practice guidelines, like those from the National Comprehensive Cancer Network, agree that Zaltrap is no better than Avastin in this setting. (Full disclosure: Two of us, Dr. Bach and Dr. Saltz, have been paid consulting fees by Genentech.)
The writers are doctors at Memorial Sloan-Kettering Cancer Center. Peter B. Bach is the director of the Center for Health Policy and Outcomes, Leonard B. Saltz is chief of the gastrointestinal oncology service and chairman of the pharmacy and therapeutics committee, and Robert E. Wittes is the physician in chief.
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