Document Detail


In a survey, marked inconsistency in how oncologists judged value of high-cost cancer drugs in relation to gains in survival.
MedLine Citation:
PMID:  22492887     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Amid calls for physicians to become better stewards of the nation's health care resources, it is important to gain insight into how physicians think about the cost-effectiveness of new treatments. Expensive new cancer treatments that can extend life raise questions about whether physicians are prepared to make "value for money" trade-offs when treating patients. We asked oncologists in the United States and Canada how much benefit, in additional months of life expectancy, a new drug would need to provide to justify its cost and warrant its use in an individual patient. The majority of oncologists agreed that a new cancer treatment that might add a year to a patient's life would be worthwhile if the cost was less than $100,000. But when given a hypothetical case of an individual patient to review, the oncologists also endorsed a hypothetical drug whose cost might be as high as $250,000 per life-year gained. The results show that oncologists are not consistent in deciding how many months an expensive new therapy should extend a person's life before the cost of therapy is justified. Moreover, the benefit that oncologists demand from new treatments in terms of length of survival does not necessarily increase according to the price of the treatment. The findings suggest that policy makers should find ways to improve how physicians are educated on the use of cost-effectiveness information and to influence physician decision making through clinical guidelines that incorporate cost-effectiveness information.
Authors:
Peter A Ubel; Scott R Berry; Eric Nadler; Chaim M Bell; Michael A Kozminski; Jennifer A Palmer; William K Evans; Elizabeth L Strevel; Peter J Neumann
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Health affairs (Project Hope)     Volume:  31     ISSN:  1544-5208     ISO Abbreviation:  Health Aff (Millwood)     Publication Date:  2012 Apr 
Date Detail:
Created Date:  2012-04-11     Completed Date:  2012-11-16     Revised Date:  2013-12-06    
Medline Journal Info:
Nlm Unique ID:  8303128     Medline TA:  Health Aff (Millwood)     Country:  United States    
Other Details:
Languages:  eng     Pagination:  709-17     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Antinematodal Agents / economics*
Attitude of Health Personnel*
Canada
Choice Behavior
Cost-Benefit Analysis
Drug Costs*
Health Care Surveys
Humans
Judgment*
Medical Oncology
Neoplasms / drug therapy*
Physicians / psychology*
Survival*
United States
Grant Support
ID/Acronym/Agency:
P50 CA101451/CA/NCI NIH HHS; P50 CA101451/CA/NCI NIH HHS; R01 CA087595/CA/NCI NIH HHS; R01 CA087595/CA/NCI NIH HHS; //Canadian Institutes of Health Research
Chemical
Reg. No./Substance:
0/Antinematodal Agents
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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