Let the third party payers rejoice: Avastin for postoperative colon cancer is no better than conventional chemo. The results were released by Genetech in a news release. Never mind that ASCO is next month and would have made a better venue to release the results. Our astute Andrew Pollack highlighted the results in NYT today--perhaps Genentech was trying to float one under the radar only to be called out by NYT! This would have added $20 000 to the price tag of treating every Stage III colon cancer patient in this country. Assume 37% of colon cancer patients are diagnosed at stage III (i.e. definitely candidates for chemotherapy) and that there are 150 000 new cases per year. They say 18% of Americans under the age of 65 have no medical insurance so let's say only 85% of the candidates actually get treated with the new medicine. This means that the current result just saved the healthcare system 150 000 x 37% x 85% x $20 000 = $943 500 000 Ok so you could quibble with my numbers some (a round of Avastin really costs $4 000 and at 12 rounds the cost is more like $24 000 but what's a few million among friends?) but isn't it interesting how much money was riding on this one result? A billion dollars. When I went to Washington a year ago the whole discussion was focused on "If we restore the $10 billion physician pay cut where is the money gonna come from?" The answer back then was Medicare Advantage. I ask the question now that was asked of me as a representative of a physician specialty group: if Avastin gets approved for adjuvant colon cancer where's the $1 billion gonna come from to pay for it? Sorry about the mini-rant here. Indications are becoming a bottomless well for pharmaceutical companies. Next stop adjuvant breast cancer chemo? There evidently is a study coming out.