Medicare recently expanded their coverage for off-label use of cancer drugs.
These medications are among the most expensive, and especially in cases of end-stage treatment, there may not be a lot of evidence supporting their use.
For the most part, oncologists and patients (via the WSJ Health Blog) have hailed the decision, but others say that the increased ability to give off-label drugs “let physicians avoid hard discussions with patients about a grim prognosis,” and that, “it makes it easier to give drug after drug [to] keep the fantasy alive.”
I find it curious that Medicare, which is under significant pressure to control costs, went this route. It doesn’t bode well for future cost control mechanisms, such as comparative effectiveness, where drugs have to be limited in the absence of appropriate medical evidence.
Did the drug makers influence their decision? And will private insurers, who eagerly replicate Medicare’s cost-cutting decisions, this time follow Medicare’s lead in expanding cancer drug coverage?