how to decide if a drug is "worth" the cost?

I have a new post up at MyBreastCancerNetwork.Com.

Living With Metastasis: Avastin - How Do We Decide If A Drug Is Worth the Cost?

Here is an excerpt (the paragraph in italics is a quote from an article in the New York Times, to which this is a response):

...If a drug like Avastin can prolong life by, let’s say four months, is it worth the cost? I know what my kids would say. Also, what exactly does it mean when it is said that patients in a clinical trial ‘lived four months longer’? I always return to Stephen J. Gould and “The Median is not the Message” when I need to be reminded that statistics do not always provide the clearest picture.

“Gailanne Reeh remembers what life was like within a few months of those initial scans, when her cancer began causing terrible symptoms.

Her abdomen grew so full of fluid that it was hard to bend to tie her shoes. Bowel movements were difficult, and even lying down was uncomfortable with that huge mass in her abdomen….After six months of treatment the fluid in her abdomen was down to just a trace, her tumors were stable or smaller and she felt like her former self again."

Quality of life is incredibly difficult to quantify. However, I am struck by how the symptoms described above are so similar to my own when the metastasis was diagnosed. The pain was excruciating. And to have those symptoms be alleviated eased not only the pain but the terror I had been feeling as well.

In my own case, as with Ms. Reeh’s, we cannot be sure how much of the improvement was due to the breakthrough drug, the chemotherapy that accompanied it or the combination of the two (although my oncologist believes it to be the latter). The relatively new and expensive drug in my case is Herceptin.

You can read the rest of this post at MyBreastCancerNetwork.Com.