It is becoming clear that the Food and Drug Administration — along with the rest of the government health-care bureaucracy — is quickly becoming the vanguard for cost controls and rationing, even to the detriment of its real mission, ensuring the safety of our drug supplies.

Readers of NRO are already aware of the FDA’s effort to limit access to the late-stage breast-cancer drug Avastin. Despite outcries from patient-advocacy groups, the agency seems intent on denying Medicare and private insurance coverage for the drug but keeping Avastin on the market for those who can afford to pay for it.

The record is clear: The FDA considered cost in their decisionmaking, although they wrapped their decision in the rhetoric of safety. The risks were too high to justify the costs, they argued. But if safety were the primary concern, why would the FDA continue to allow people who can afford it to use the drug?

The FDA isn’t alone. The National Institutes for Health’s handling of another drug, Lucentis, is further evidence that costs are becoming a primary driver of government policy.

Lucentis is a drug approved by the FDA to treat wet age-related macular degeneration (AMD). It happens to be made by the same manufacturer as Avastin.

The FDA has never approved Avastin for use in AMD. It has never been fully tested for safety. But the NIH is moving forward with its own, unprecedented pseudo-study — one that does not meet FDA guidelines for drug approval — to determine whether Avastin should be substituted for Lucentis. What makes Avastin so attractive to the NIH? The price: Avastin is actually less expensive than Lucentis.

Once again, the government is pursuing a policy of “cheaper is better” — even if it does not help patients. Lucentis was tested and approved and has been shown to stop the sight deterioration caused by AMD. Avastin was not. Yet the government is arguing that Avastin — which was never tested and has not been approved for AMD use — may be more cost-effective than an FDA-approved drug, even if there will be greater risks for patients.

Gilbert Ross outlined the dangers of this policy in the LA Times:

Letting regulators bring down costs by sacrificing quality of care sets a bad precedent that could have consequences for our entire health system. Just look at Great Britain. That government’s National Institute for Health and Clinical Effectiveness, or NICE, has long been denying treatments to British citizens for cost reasons.

From the FDA to the NIH, it’s clear that the health-care bureaucracy is willing, in the age of Obamacare, to ration drugs and put patients at risk if the price is right. These aren’t “death panels”; they’re worse. When rationing bureaucrats decide which drugs you get from a list of government-approved options, that list must first be put together by agencies like the FDA. What makes it on that list and what doesn’t is where the real danger lies, and it runs risk of flying under the radar.

— Derek Hunter is a radio host on WMAL in D.C. and a former health-policy analyst at the Heritage Foundation.