Delivering affordable cancer care in high-income countries Journal Article
| Authors: | Sullivan, R.; Peppercorn, J.; Sikora, K.; Zalcberg, J.; Meropol, N. J.; Amir, E.; Khayat, D.; Boyle, P.; Autier, P.; Tannock, I. F.; Fojo, T.; Siderov, J.; Williamson, S.; Camporesi, S.; McVie, J. G.; Purushotham, A. D.; Naredi, P.; Eggermont, A.; Brennan, M. F.; Steinberg, M. L.; De Ridder, M.; McCloskey, S. A.; Verellen, D.; Roberts, T.; Storme, G.; Hicks, R. J.; Ell, P. J.; Hirsch, B. R.; Carbone, D. P.; Schulman, K. A.; Catchpole, P.; Taylor, D.; Geissler, J.; Brinker, N. G.; Meltzer, D.; Kerr, D.; Aapro, M. |
| Article Title: | Delivering affordable cancer care in high-income countries |
| Abstract: | The burden of cancer is growing, and the disease is becoming a major economic expenditure for all developed countries. In 2008, the worldwide cost of cancer due to premature death and disability (not including direct medical costs) was estimated to be US$895 billion. This is not simply due to an increase in absolute numbers, but also the rate of increase of expenditure on cancer. What are the drivers and solutions to the so-called cancer-cost curve in developed countries? How are we going to afford to deliver high quality and equitable care? Here, expert opinion from health-care professionals, policy makers, and cancer survivors has been gathered to address the barriers and solutions to delivering affordable cancer care. Although many of the drivers and themes are specific to a particular field-eg, the huge development costs for cancer medicines-there is strong concordance running through each contribution. Several drivers of cost, such as over-use, rapid expansion, and shortening life cycles of cancer technologies (such as medicines and imaging modalities), and the lack of suitable clinical research and integrated health economic studies, have converged with more defensive medical practice, a less informed regulatory system, a lack of evidence-based sociopolitical debate, and a declining degree of fairness for all patients with cancer. Urgent solutions range from re-engineering of the macroeconomic basis of cancer costs (eg, value-based approaches to bend the cost curve and allow cost-saving technologies), greater education of policy makers, and an informed and transparent regulatory system. A radical shift in cancer policy is also required. Political toleration of unfairness in access to affordable cancer treatment is unacceptable. The cancer profession and industry should take responsibility and not accept a substandard evidence base and an ethos of very small benefit at whatever cost; rather, we need delivery of fair prices and real value from new technologies. © 2011 Elsevier Ltd. |
| Keywords: | cancer chemotherapy; cancer surgery; fludarabine; review; intensity modulated radiation therapy; bevacizumab; cisplatin; fluorouracil; patient selection; united states; cancer radiotherapy; rituximab; outcome assessment; antineoplastic agent; cancer incidence; evidence based medicine; neoplasms; colorectal cancer; medical decision making; gastrointestinal stromal tumor; imatinib; carboplatin; progression free survival; breast cancer; lung non small cell cancer; practice guideline; molecular imaging; diagnostic imaging; surgical approach; cetuximab; cancer therapy; shelf life; cancer mortality; cancer survivor; irinotecan; panitumumab; europe; health care policy; health care quality; cost effectiveness analysis; drug cost; health care cost; health care utilization; health economics; health insurance; reimbursement; health expenditures; health policy; genome analysis; medical education; folinic acid; developed country; public health; gefitinib; clinical research; health services research; malignant neoplastic disease; stomach cancer; australia; aging; nuclear medicine; terminal care; taxane derivative; cancer control; trastuzumab; navelbine; oxaliplatin; health care costs; stereotactic body radiation therapy; chronic lymphatic leukemia; pemetrexed; united kingdom; quality adjusted life year; cost-benefit analysis; health care delivery; alemtuzumab; health care access; socioeconomic factors; cost savings; personalized medicine; insurance, health; randomized controlled trial (topic); health services accessibility; phase 2 clinical trial (topic); phase 3 clinical trial (topic); health care reform; healthcare disparities; pharmacogenomics; ofatumumab; social care; delivery of health care, integrated; physical disability; health care availability; gross national product; models, economic; patient advocacy; health care distribution; political participation; health services misuse |
| Journal Title: | Lancet Oncology |
| Volume: | 12 |
| Issue: | 10 |
| ISSN: | 1470-2045 |
| Publisher: | Elsevier Science, Inc. |
| Date Published: | 2011-09-01 |
| Start Page: | 933 |
| End Page: | 980 |
| Language: | English |
| DOI: | 10.1016/s1470-2045(11)70141-3 |
| PROVIDER: | scopus |
| PUBMED: | 21958503 |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 6" - "Export Date: 2 November 2011" - "CODEN: LOANB" - "Source: Scopus" |
