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Interesting excerpt from the NEJM article referenced above. I believe this was discussed on our website a few weeks ago>
Regards
Joe
To the Editor: Remarkable advances in the treatment of breast cancer with trastuzumab were recently reported, but the use of this drug can result in substantial financial losses for the providers of the medication. Trastuzumab is sold by Genentech in 440-mg multidose vials. When a dose is prepared according to the package insert with the use of the supplied diluent, only 420 mg of trastuzumab per vial can be removed. The Centers for Medicare and Medicaid Services (CMS) sets the payment for trastuzumab on the basis of information supplied to the provider by Genentech, and the CMS assumes, on the basis of its calculations, that 440 mg can be obtained from each vial.
This difference of 5 percent is important because of the tremendous cost of trastuzumab. Each vial provides treatment for one to three patients, and each vial costs about $2,300. The loss to the provider is about $100 per vial. The total sales of trastuzumab in 2004 were $483 million. The loss incurred by providers was therefore more than $20 million. These losses will increase with expanded use of trastuzumab. The compelling nature of the results reported challenges Genentech to provide this valuable medication in a preparation that does not penalize providers.
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