U.S. spends more on cancer care, but gains time in return

Apr 12 2012

A new analysis published in Health Affairs found that American cancer patients lived almost two years longer than those in 10 European countries -- leading the researchers to say that the additional expense is worth it.   

Reuters: Is High Spending On Cancer Care 'Worth It'?
With the United States spending more on health care than any other country -- $2.5 trillion, or just over $8,000 per capita, in 2009 -- the question has long been, is it worth it? At least for spending on cancer, a controversial new study answers with an emphatic "yes." Cancer patients in the United States who were diagnosed from 1995 to 1999 lived an average 11.1 years after that, compared with 9.3 years for those in 10 countries in Europe, researchers led by health economist Tomas Philipson of the University of Chicago reported in an analysis published Monday in the journal Health Affairs (Begley, 4/9).

Kaiser Health News: Capsules: Research Weighs Higher U.S. Costs For Cancer Care
Higher U.S. spending for cancer care pays off in almost two years of additional life for American cancer patients on average compared to their European counterparts -- a value that offsets the higher costs --according to a study in the April issue of the journal Health Affairs (Barr, 4/9).

NPR: With Cancer Care, The U.S. Spends More, But Gets More
And what it found is that for most types of solid tumor cancers, particularly breast and prostate cancer, even after considering the higher costs, U.S. patients experienced greater survival gains than patients in Europe. And those costs did grow. Between 1983 and 1999, the period covered by the study, U.S. spending on cancer care grew 49 percent (in 2010 dollars). By comparison, spending in the 10 European countries included in the study grew by 16 percent (Rovner, 4/9).

But treatments decisions aren't simple for physicians or patients --

Politico Pro: Study: Doctors Vary On Costly Cancer Care
In recommending cancer treatments, doctors don't always pay much attention to the price of extending a patient's life -- and sometimes they don't follow their own guidelines. A new Health Affairs study led by Dr. Peter A. Ubel of Duke University examines how oncologists make cost-effective decisions when new drugs on the market, such as Avastin, cost hundreds of thousands of dollars. When asked what would be a reasonable definition of cost per additional year of life for a cancer patient, most doctors indicated that a drug with a ratio of less than $100,000 per year of life is worthwhile. But in a hypothetical scenario in which doctors were given the option of prescribing an expensive new drug of varying cost, oncologists presented with more expensive drugs endorsed them (Smith, 4/9).

WHYY/Marketplace: Gambling On Cancer Treatments
Here's a tough question: If you had cancer, which of these treatments would you choose? Traditional chemotherapy that would guarantee an extra year or two of life but no more. Or an experimental drug that could extend your life by at least four years, but had only a 10 percent shot of working. A study in today's issue of HealthAffairs asked over a hundred patients that question (Warner, 4/9).

In other news --

Boston Globe: 60 Percent Of Cancer Patients Die In A Hospital, Dartmouth Study Finds
Although most Americans say they want to die at home, not hooked up to a hospital ventilator, many doctors still feel compelled to treat even terminal cancer with the most aggressive care. Sixty percent of cancer patients die in a hospital, one-quarter of them in intensive care. And it makes no difference whether patients are treated by doctors at community hospitals, teaching hospitals or specialized cancer care centers, according to a study of Medicare patients released Monday afternoon (Weintraub, 4/9).