Greedy Trial Lawyer
Drugs Oncologists Don't Administer Don't Get Prescribed
Category: Gaming The System
Some doctors hate competition and love money so much they don't even mention the possible use of the two most promising drugs in the treatment of Non-Hodgkin's lymphoma.
Market Forces Cited in Lymphoma Drugs' Disuse
Non-Hodgkin's lymphoma is the fifth most common cancer in the United States, with 60,000 new cases and almost 20,000 deaths a year. But fewer than 2,000 patients received Bexxar or Zevalin last year, only about 10 percent of those who are suitable candidates for the drugs."Both Zevalin and Bexxar are very good products," said Dr. Oliver W. Press, a professor at the University of Washington and chairman of the scientific advisory board of the Lymphoma Research Foundation. "It is astounding and disappointing" that they are used so little. The reasons that more patients don't get these drugs reflect the market-driven forces that can distort medical decisions, Dr. Press and other experts on lymphoma treatment say. A result can be high costs but not necessarily the best care.
The drugs have not been clinically proven to prolong survival, compared with other therapies. But patients are more likely to respond to them than standard treatments, and trials to test whether the drugs do have a survival benefit are nearly complete.
Other, more thoroughly tested lymphoma drugs are preferred as first-line treatments. But doctors often repeatedly prescribe such drugs even after they have lost their effectiveness -- and when Bexxar and Zevalin might work better.
One reason is that cancer doctors, or oncologists, have financial incentives to use drugs other than Bexxar and Zevalin, which they are not paid to administer. ["Because the drugs are radioactive, they must be administered in a hospital, not a doctor's office. Therefore, oncologists do not get paid for prescribing them, as they are when they give chemotherapy." From the Cancer Blog]
In addition, using either drug usually requires oncologists to coordinate treatment with academic hospitals, whom the doctors may view as competitors.
As a result, many doctors prescribe Bexxar and Zevalin only as a last resort, when they are unlikely to succeed because the cancer has advanced. "Oncologists use everything in their cupboard before they refer," Dr. Press said. "At least half the patients who get referred to me have had at least 10 courses of treatment." [I can only imagine the dollar bills vacuumed by the oncologist who can put a patient through 10 courses of chemotherapy.]
From the New York Times
Does the word unethical come to mind?
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