Sally C. Pipes

Because with a $2,000-plus price differential, the federal government -- and by extension, Medicare -- would love nothing more than to have indisputable scientific proof on its side to sway doctors to prescribe the much cheaper Avastin. With Obamacare's various mandates and programs burdening an already strained and expensive health care system, it's a sure bet that corners will start being cut to save money where possible.

The dangerous precedent this study creates is for the gradual integration of a government-enforced cheaper-is-better principle in health care. Even if Lucentis and Avastin are shown in the NEI study to be identical in their safety and effectiveness, no doctor would claim that's true in each and every individual case. The average results will be the headline conclusion in the executive summary, but for some patients, it will inevitably be the case that, for whatever reason, Lucentis -- or Avastin -- is a better choice.

It isn't in the best interest of any doctor to cavalierly opt for Lucentis if Avastin will work just as effectively. But it's all too easy to imagine Medicare slapping a "fail first" policy on Lucentis - in other words, coverage for the pricier drug only gets green-lighted for a patient if Avastin is ineffective. A "fail first" policy would strong-arm doctors into choosing Avastin even if they believe a patient would respond better to Lucentis.

Such a course may be cheaper. But the real cost is in value for patients, who deserve access to the highest quality care available -- not simply those treatments that offer the biggest bang for the insurer's or the government's buck.


Sally C. Pipes

Sally C. Pipes serves as a health care advisor to The Rudy Giuliani Presidential Committee. She is President and CEO of the Pacific Research Institute. She is author of Miracle Cure: How to Solve America’s Crisis and Why Canada Isn’t the Answer.

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