March 27, 2007
Europe should be sharing in the progress against cancer, but large bureaucracies have been erected to contain costs, by slowing the introduction of new drugs and restricting how doctors can use them, says Scott Gottlieb, a physician and resident fellow at the American Enterprise Institute.
Since European drug regulators do not allow new medicines to reach patients until government negotiators have extracted a favorable price from sponsors, cancer drugs are often available in the United States months if not years earlier:
- In 2003, when 31 new drugs were launched worldwide, about 60 percent were available here months before Europe.
- Between 1995 and 2001 the 15 cancer drugs approved in Europe and the United States took 468 days to reach patients in Europe versus 273 days in America.
- Herceptin was tangled up in a 550-day approval process as the Europeans fought for a lower price, while the United States approved it in fewer than 120 days.
Driving hard bargains also means imposing conditions on who can access new drugs by refusing to pay for many uses, even those approved by world regulatory authorities, says Gottlieb.
There is a price for these policies, says Gottlieb:
- A study done in 2003 for Britain's National Health Service found that, long after its approval, more than 1,000 eligible British women with breast cancer were still not receiving Herceptin.
- Five-year survival for breast cancer caught early in England is 78 percent, compared to 98 percent in the United States.
- In Germany, a study found that 41 percent of German physicians were treating early breast cancer with taxanes, compared to 60 percent in America at the time.
- German breast cancer mortality decreased by 9 percent from 1990 to 1998, while mortality in the United States dropped more than twice as much.
Source: Scott Gottlieb, "Breast-Cancer Breakthroughs," Wall Street Journal, March 26, 2007.
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