Document Detail


The value of new chemotherapeutic agents for metastatic colorectal cancer.
MedLine Citation:
PMID:  20233802     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
David H Howard; John Kauh; Joseph Lipscomb
Publication Detail:
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:
Title:  Archives of internal medicine     Volume:  170     ISSN:  1538-3679     ISO Abbreviation:  Arch. Intern. Med.     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-03-23     Completed Date:  2010-05-04     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372440     Medline TA:  Arch Intern Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  537-42     Citation Subset:  AIM; IM    
Affiliation:
Department of Health Policy and Management, Emory University, Atlanta, GA 30030, USA. david.howard@emory.edu
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MeSH Terms
Descriptor/Qualifier:
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:
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:
0/Antineoplastic Agents

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


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