Cancer Treatment Costs are Worth It
[T]he cost of cancer treatment in the United States was higher than such care in ten European countries from 1983 to 1999. However, they also found that for most cancer types investigated, U.S. cancer patients lived longer than their European counterparts. Cancer patients diagnosed during 1995-99, on average, lived 11.1 years after diagnosis in the United States, compared to just 9.3 years from diagnosis in Europe.
The researchers concluded that by standard metrics that value additional years of life in dollar terms, U.S. cancer patients paid more but achieved better results in terms of longevity. Even after considering higher U.S. costs for treatment, their calculations showed the extra longevity was worth an aggregate of $598 billion — an average of $61,000 for an individual cancer patient. The value of additional survival gains was highest for prostate cancer patients ($627 billion) and breast cancer patients ($173 billion).
Full Health Affairs study worth reading.
Cancer treatments make for a great natural experiment. Some European countries refuse to provide access to all of the expensive therapies that are common in the United States, while other European countries provide these treatments. In countries that skimp on expensive cancer treatments (such as the United Kingdom), survival rates are significantly lower.
This is fascinating. It’s also consistent with my expectations.
Survival rates are a pretty flawed measurement for the effectiveness of cancer treatment, since they can be influenced by early detection (which the paper addressed, but not adequately in my opinion) and overdiagnosis (which it did not address). There are some good explanations for why Philipson’s analysis is problematic in this Reuters article:
http://www.reuters.com/article/2012/04/09/us-cancercare-idUSBRE8380SA20120409
These results are consistent with the results of other studies i have seen.
The title of the article implies that the extra money is what makes the difference in outcomes. But since the average life expectancy is longer on average in Europe, using the same logic, mustn’t there be other treatments that would benefit from less spending?
What Eric says …
http://theincidentaleconomist.com/wordpress/maybe-we-can-have-a-better-press-corp/
I wonder what the quality of life would be for that extra 1.8 years that U.S. cancer patients lived.
Not that such could be quantified, I’m just saying.
To be fair, the paper shows some cancer expenditures are worth it, namely breast and prostate. We did not fare as well on colon or uterine. It doesn’t ake sense to say that therefore throwing more money brings back equivalent value, only that for breast and prostate, more expenditure has returned significant extensions on people’s lives. And this makes sense.
I can guarantee you, similar expenditures on pancratic cancer or GBM patients would not create similar dividends, the two cancers emphasized by the study just happen to be two cancers in which we’ve made enormous strides in the last couple of decades.
So what does this mean? It’s certainly not a vindication of the US system as a whole, or even in part. Just for two diseases, spending more money improves mortality. But not for other cancers, and if anything, the opposite for colon and uterine. I wouldn’t overblow it, despite attempts to generalize it to the whole system from the AEI-funded authors.
Jeez, I didn’t even pick up on the survival rate issue on the first pass. Thanks guys.
Yea, this paper is total junk.
MarkH says: Yea, this paper is total junk.
Funny thing is that this paper is getting the press it was meant to. It’s been copied and pasted with little or no analysis on news sources everywhere. Those will filter down into right wing blogs that will offer “proof” that “socialized medicine” is a failure.
There seems to be a concerted effort on the right to use junk science to question anything that gets in the way of their agenda. Then knuckle dragging bloggers all over the world pick the stories up, often only reading snippets and offer them up as “proof”.
For what it’s worth, the paper was funded (in part) by Bristol-Myers-Squibb, a pharmaceutical company that presumably is involved in making a lot of the expensive cancer treatments that (per Devon Herrick) other countries “skimp” on. I wouldn’t go as far to say that this influenced the results, but there is a pretty clear conflict of interest here that was not really reported in most outlets.
Pancreatic cancer can be trtaeed for cure under very specific conditions. It spreads by local invasion and via lymphatic channels. If it is caught early prior to invasion in the local vasculature, it can be trtaeed for cure via several procedures Whipple (pancreaticoduodenectomy), Total Pancreatectomy, or Distal Pancreatectomy. A major issue is catching it early. The symptoms of this disease early on are usually no symptoms, vague abdominal pain, mild discomfort. It is hard to detect. There is also no good screening that is cost effective. The reason for this is the cancer is not that common, and the tests available are not that cheap. This makes for a very inefficient screening method. The ones out there currently that can detect pancreatic cancer include CT scan of the abdomen and Endoscopic Ultrasound. Both of these tests have their own drawbacks. CT scan of the abdomen involves radiation that may set you up for a cancer. Endoscopic ultrasound requires sedation, a specialist (gastroenterologist), and has risks of perforation. Also the tests need to have a high degree of sensitivity (meaning that there is a high number of people who have the disease also test positive). Endoscopic ultrasound is being used more for symptomatic pancreatic cancer, but I do not know of studies used for screening the general population.Another issue is it’s proximity to other organs. It is near the duodenum, stomach, inferior vena cava, aorta. It is also a part of the biliary system and liver. It can spread to many important organs easily.There is some increased hope on the horizon as new chemotherapy drugs are being developed. Dr. Vickers at the University of Minnesota is doing clinical trials on a new medication that will hopefully help with treating the disease.