Minerva

Expensive anticancer drugs and other stories . . .

BMJ 2014; 349 doi: https://doi.org/10.1136/bmj.g5054 (Published 13 August 2014) Cite this as: BMJ 2014;349:g5054

The median survival benefit of the 71 drugs licensed by the US Food and Drug Administration for the treatment of solid tumours since 2002 is 2.1 months. This figure comes from an article hidden away in JAMA Otolaryngology Head and Neck Surgery (2014, doi:10.1001/jamaoto.2014.1570) called “Unintended Consequences of Expensive Cancer Therapeutics—the Pursuit of Marginal Indications and a Me-Too Mentality that Stifles Innovation and Creativity.” And these few weeks of extra life usually come at a cost of tens of thousands of dollars and severe adverse effects.

Trials of anticoagulation for atrial fibrillation usually choose stroke, death, and major bleeding as their primary endpoints. Perhaps they should add cognitive decline, which seems to be strongly associated with embolic events. In a cohort study of 935 participants who were free of atrial fibrillation or stroke at the start, 48 developed atrial fibrillation over 11 years (Stroke 2014, doi:10.1161/STROKEAHA.114.005243). Of these, only the 16 with subclinical infarcts on brain magnetic resonance imaging showed cognitive impairment during …

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