Yesterday’s NY Times has a good article about a minor controversy.  The NEJM published a paper showing that treating superficial vein thrombosis could have a small but significant benefit.

The study of 3,002 people with superficial-vein thrombosis showed that the condition worsened to deep vein thrombosis or pulmonary embolism in 1.3 percent of those who took a placebo for 45 days and 0.2 percent of those who took the drug Arixtra.

It was an excellent, randomized, double-blind study that reported statistically significant results, Dr. Goldman and Dr. Jeffrey S. Ginsberg, a blood expert, wrote in the editorial.

But the study did not talk about the costs, they wrote, which could range from $2,124 to $7,380 a person for 45 days of injections, or at least $186,000 for 88 people to avoid one new problem.

“The paradox is, it’s effective, but for a condition that’s usually not considered an overwhelmingly serious medical problem,” Dr. Goldman said in an interview. “The fact that it’s a medicine that’s expensive really raises an issue, not just for this trial, but we tried to make the point more broadly.”

Drs. Goldman and Ginsberg deserve commendation.  Obviously the drug company will promote their expensive drug widely, and likely make money from its use.  I hope insurance companies do not pay for this drug for this indication.  This is too much.

We must draw the line somewhere.  The editorial makes the point clearly and, I believe, well.