Justifying insurance coverage for orphan drugs

Tuesday, February 7, 2012 - 17:00 in Health & Medicine

How can insurers justify spending hundreds of thousands of dollars per patient per year on "orphan drugs" – extremely expensive medications for rare conditions that are mostly chronic and life-threatening -- when this money could provide greater overall health benefit if spread out among many other patients? Those spending decisions reflect the "rule of rescue," the value that our society places on saving lives in immediate danger at any expense. But the broad application of the rule of rescue will be increasingly difficult to support as "personalized medicine" produces more drugs genetically targeted to relatively small groups of patients, concludes an article in the Hastings Center Report. For example, rather than a new blockbuster drug that treats millions with hypertension, new targeted therapies will treat only those few thousand with a particular genetic makeup.

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