| The value of new chemotherapeutic agents for metastatic colorectal cancer. | |
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MedLine Citation:
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PMID: 20233802 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: New chemotherapeutic agents for patients diagnosed with metastatic colorectal cancer have been singled out as examples of high-cost/low-value medical care. We measure trends in life expectancy and lifetime medical costs in this patient population between January 1, 1995, and December 31, 2005. METHODS: Using the Surveillance, Epidemiology, and End Results-Medicare database, we constructed a sample of 4665 patients aged 66 and older diagnosed with metastatic colorectal cancer between January 1, 1995, and December 31, 2005, who received chemotherapeutic agents. We estimated life expectancy and lifetime medical costs based on observed short-term survival rates and costs. RESULTS: Life expectancy increased by 6.8 months and lifetime costs by $37 100 (2006 dollars). The implied cost per life-year gained is $66 200 (95% confidence interval, $48 100-$84 200). After discounting life-years and costs and adjusting for patients' health utility and out-of-pocket payments, the cost per quality-adjusted life-year gained is $99 100 (95% confidence interval, $72 300-$125 900). CONCLUSIONS: New chemotherapeutic agents are associated with improvements in survival time but also with substantial costs. The cost-effectiveness ratio for these drugs as a group is below commonly cited estimates of the willingness-to-pay for a life-year. However, open-ended coverage policies for new chemotherapeutic agents may prove difficult to sustain as costs continue to rise. |
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Authors:
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David H Howard; John Kauh; Joseph Lipscomb |
Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S. Date: 2010-03-16 |
Journal Detail:
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Title: Archives of internal medicine Volume: 170 ISSN: 1538-3679 ISO Abbreviation: Arch. Intern. Med. Publication Date: 2010 Mar |
Date Detail:
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Created Date: 2010-03-23 Completed Date: 2010-05-04 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0372440 Medline TA: Arch Intern Med Country: United States |
Other Details:
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Languages: eng Pagination: 537-42 Citation Subset: AIM; IM |
Affiliation:
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Department of Health Policy and Management, Emory University, Atlanta, GA 30030, USA. david.howard@emory.edu |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aged Aged, 80 and over Antineoplastic Agents / economics, therapeutic use* Colorectal Neoplasms / drug therapy*, economics, pathology* Cost-Benefit Analysis Female Humans Life Expectancy* Male Neoplasm Metastasis / drug therapy* Neoplasm Staging Treatment Outcome |
| Grant Support | |
ID/Acronym/Agency:
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N01-PC-35136/PC/NCI NIH HHS; N01-PC-35139/PC/NCI NIH HHS; N02-PC-15105/PC/NCI NIH HHS; U55/CCR921930-02//PHS HHS |
| Chemical | |
Reg. No./Substance:
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0/Antineoplastic Agents |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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