New chemotherapy agents appear associated with improvements in survival time for patients with metastatic colorectal cancer but at substantial cost.
David H. Howard, PhD, and colleagues at Emory University's Rollins School of Public Health (RSPH), used a cancer registry database to measure trends in life expectancy and lifetime medical costs in 4,665 patients age 66 and older diagnosed with metastatic colon cancer between 1995 and 2005. Patients were classified according to whether they received one or more of the six chemotherapeutic agents approved for the treatment of metastatic colon cancer between 1996 and 2004.
Among those who received the new agents, life expectancy increased by 6.8 months and lifetime costs increased by $37,100, equating to a cost of $66,200 per year of life gained. After additional adjustments, the cost for each quality-adjusted life year (a year of life in perfect health) gained was $99,100, says lead study author Howard, associate professor of health policy and management, RSPH.
"New chemotherapeutic agents for colorectal cancer have been singled out as examples of high-cost/low-value medical care; no doubt they are the types of therapies that would receive close scrutiny if Medicare and other payers were to consider cost-effectiveness in coverage decisions," Howard and co-authors write.
"Our estimate of the cost per quality-adjusted life year gained, $100,000, is below most estimates of the willingness to pay for a life-year," the authors say. "However, continuation of Medicare's open-ended coverage policy for new chemotherapeutic agents and other expensive technologies will prove difficult to sustain as costs for the program continue to rise."
The study, "The Value of New Chemotherapeutic Agents for Metastatic Colorectal Cancer," is published in the March 16, 2010 issue of the Archives of Internal Medicine, a publication of the American Medical Association.
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