Benefit vs. social responsibility: a profound ethical dilemma in medicine today

Brilinta, at $6.50 per pill, twice a day, reduces cardiovascular events more than generic Plavix, which costs 50 cents per pill, once a day. But only a little: 20% relative or 2% absolute risk reduction. The event risk was 10% with the more expensive drug and 12% with the one that costs 82% less. Put differently, if 100 patients were treated with Brilinta for a year, at a cost of $4,680 for each patient, ten patients would still have an event. With clopidogrel, 100 patients, each one at a cost of $180, 12 events would occur. That means two fewer events would happen per 100 patients on Brilinta at an extra cost of $450,000, or $225,000 per avoided cardiovascular emergency (number needed to treat, NNT=50). This is described in a New York Times article as a profound ethical dilemma in medicine today: Continue reading ... Your patients are rating you online: How to respond. Manage your online reputation: A social media guide. Find out how.
Source: Kevin, M.D. - Medical Weblog - Category: General Medicine Authors: Tags: Policy Cardiology Public Health & Source Type: blogs