Weighing the Risks of a Drug: Tamoxifen
So… let’s say that you are a woman that has been told by your doctor that you are “at risk” of breast cancer… NOT that you have it, mind you, just that you are statistically “at risk.” So, the doctor recommends (as a precaution) that you begin taking a drug called “Tamoxifen.” Then you start doing some reading… you find that a new study has determined that not only does Tamoxifen NOT reduce your chance of contracting breast cancer, it actually INCREASES your chances of developing endometrial cancer, cataracts and blood clots! And, it turns out that they also found the drug to be extraordinarily expensive from a public policy point of view, costing up to $1.3 million per year of life “saved.” So… would you take it? Ah ha. Thought not. Will they tell you all this “up front?” That’s the question!
“In other words, even though the drug may help prevent many cases of more curable hormone receptor-positive cancers, it is not effective in protecting against more deadly receptor-negative tumors. Added to that is the raised risk for endometrial cancer and blood clots among women taking tamoxifen. The end result is no difference in mortality for many high-risk women using the drug, the researchers concluded. Meanwhile, the mathematical model found that the drug cost as much as $1.3 million per year of life saved, based on the U.S. price of the drug. That’s a concern not only for public policy makers, she said, but also for individual women. For example, a patient living in the Sacramento area can expect to pay between $240 and $1,500 per year for tamoxifen. The bottom line: ‘For most women, they don’t think it is going to help improve survival,’ said Dr. Herman Kattlove, medical editor for the American Cancer Society who is familiar with the analysis. ‘If you are in the [high range] of the high-risk group, it may help survival. But ‘may’ is the operative word.’ The drug does decrease the chance of getting breast cancer, he added.”