title: Dare we count the cost of cancer chemotherapy?
abstract: During 1972-1976, when the incidence of cancer rose only slightly in the United Kingdom and the number of cancer patients seen at a large metropolitan teaching hospital and oncological centre remained largely unchanged, the use of cytotoxic drugs rose from 5.1% to 14% of the hospital's total drug budget. Most of the rise in cost can be ascribed to the increased use and increased unit cost of four effective but expensive drugs. Although the cost of drugs is but a small proportion of the cost of care of the cancer patient, it is argued that cytotoxic chemotherapy cannot offer a "cheap alternative" to surgery and radiotherapy. In a health service with cash spending limits the use of the more expensive cytotoxic drugs should be limited to the treatment of patients in whom "cure" or long-term ablation of disease is being attempted or to protocol studies in which their effectiveness is compared with that of other, possibly less expensive, drugs. Further studies are required of the use of the less expensive cytotoxic drugs in order to maximise their usefulness in the palliative treatment of advanced disease.
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001761:Bleomycin / Q000627:therapeutic use; D002173:Cancer Care Facilities / Q000191:economics* / Q000706:statistics & numerical data; D003365:Costs and Cost Analysis; D003520:Cyclophosphamide / Q000627:therapeutic use; D004317:Doxorubicin / Q000627:therapeutic use; D006746:Hospital Bed Capacity, 500 and over; D006782:Hospitals, Special / Q000191:economics*; D006784:Hospitals, Teaching; D006801:Humans; D002955:Leucovorin / Q000627:therapeutic use; D008131:London; D008510:Medication Systems, Hospital / Q000191:economics*; D008727:Methotrexate / Q000627:therapeutic use; D009369:Neoplasms / Q000188:drug therapy* / Q000191:economics; D010607:Pharmacy Service, Hospital / Q000191:economics*; D014750:Vincristine / Q000627:therapeutic use
chemical_list: D000970:Antineoplastic Agents; D001761:Bleomycin; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D002955:Leucovorin; D008727:Methotrexate