June 30, 2009

Medical Professionals Issue Cost-Benefit Analysis Of Cancer Therapies

Two experts from the National Institutes of Health have released a new report which questions the use of expensive treatments for cancer patients that only extend their lifespan for a short time.

In comments published in the Journal of the National Cancer Institute, Tito Fojo, of the Medical Oncology Branch, Center of Cancer Research at the National Cancer Institute, in Bethesda, Maryland, and Christine Grady, of the Department of Bioethics, the Clinical Center at the National Institutes of Health, said the use of such therapies "is a serious ethical dilemma in the U.S. that needs to be addressed by the oncology community."

Fojo and Grady say the cost of such treatments should come into play when determining whether or not they are likely to add long-term benefits to patients.

They illustrate cost-benefit relationships for cancer drugs including cetuximab for treatment of non-small cell lung cancer, touted as "practice changing" and new standards of care by professional societies, including the American Society of Clinical Oncology, authors said.

An 18-week treatment of Merck's cetuximab is estimated to cost about $80,000, but the treatment only amounts to an average lifespan extension of 1.2 months.

"Is an additional 1.7 months [the additional overall survival for colorectal cancer patients treated with cetuximab] a benefit regardless of costs and side effects?," Fojo and Grady asked.

That translates into an overall cost of $800,000 per lung cancer patient to extend their life by just one year.

"At this rate, it would cost $440 billion annually, an amount 100 times NCI's budget, to extend the lives of 550,000 Americans who die of cancer annually by 1 year," authors concluded.

"The current situation cannot continue. We cannot ignore the cumulative costs of the tests and treatments we recommend and prescribe. As the agents of change, professional societies, including their academic and practicing oncologist members, must lead the way," Fojo and Grady wrote.

"The time to start is now."


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