Of value: A discussion of cost, communication, and evidence to improve cancer care.
The U.S. spends far more per person than any other country in the world in treating cancer, without demonstrably superior results. Though the pursuit and pace of innovation in oncology are perhaps unmatched and promise great benefit for cancer patients, this explosion of innovation has been accompanied by dramatic increases in cost, often without significant increases in patient survival. These trends have led to a growing interest in addressing value--understood as treatment benefits or quality weighed against economic cost--in cancer care. In February 2009, the Institute of Medicine convened a group of experts with diverse perspectives, including those of clinical oncology, patient advocacy, the insurance industry, pharmaceutical manufacturing, health economics, and bioethics, to identify challenges to value in cancer care, suggest potential solutions, and discuss what value entails in oncology. This article presents many of the ideas that emerged from this symposium, including ways to correct misaligned economic incentives, improve clinical communication, and generate evidence to promote value in cancer care.
University of California, San Francisco, USA. Adam.Schickedanz@ucsf.edu
Adam
A
Schickedanz
D026688:Bioethical Issues; D002140:California; D003226:Congresses as Topic; D017281:Cost of Illness; D016527:Drug Costs; D004345:Drug Industry / Q000191:economics; D019317:Evidence-Based Medicine; D017048:Health Care Costs; D006297:Health Services Accessibility / Q000191:economics; D006801:Humans; D033183:Interdisciplinary Communication; D015969:National Academies of Science, Engineering, and Medicine, U.S., Health and Medicine Division; D009369:Neoplasms / Q000191:economics* / Q000401:mortality / Q000628:therapy*; D010344:Patient Advocacy; D011787:Quality of Health Care / Q000191:economics* / Q000331:legislation & jurisprudence / Q000592:standards; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D016019:Survival Analysis; D014481:United States