The NY Times has an article about how a biotech drug that basically is no better than a generic is selling off the shelves at $4,200 a Dose. Doctors think it’s better, patients believe it’s better and payers are too wimpy to stand up to them. Of course they haven’t got a government agency to help them, as exists in the UK.
Interestingly enough this is exactly what happened nearly twenty years ago with one of the the first major biotech drug, Genetech’s Activase (tPA) for the immediate treatment of heart attacks. it cost about ten times what the competing drug (streptokinse) cost, and basically had no better results. At the time there was lots of murky stuff including a positive NEJM article written by scientists with close (and undisclosed) ties to the company. (If you want to know much more about that ugly debate, look at the debate starting at page 3 in this link and particularly the far right column of page 9). And then after a study showed incredibly small relative and absolute benefits in survival from using Activase, allegedly Genetech sent lawyers to lots of hopsitals explaining what a jury might say now that a lawyer could "prove" they weren’t using the best possible drug. Pretty soon everyone switched over.
Sounds like despite lots of talk about cost-benefit analysis, cost controls, and pharmaco-economics, nothing has changed.