Value and cancer care: toward an equitable future

Health care expenses in the United States are increasing inexorably. At the current rate of growth, it is anticipated that 20% of the gross national product will consist of health-related expenditures within the next decade. Cancer is the second leading cause of death in the United States, and it is...

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Bibliographic Details
Published in:Clinical cancer research 2010-12, Vol.16 (24), p.6004-6008
Main Authors: Schnipper, Lowell E, Meropol, Neal J, Brock, Dan W
Format: Article
Language:English
Subjects:
Cost of Illness
Forecasting
Health Care Costs - trends
Health Priorities - economics
Health Priorities - ethics
Humans
Neoplasms - economics
Neoplasms - epidemiology
Neoplasms - mortality
Neoplasms - therapy
Physician-Patient Relations
Prevalence
United States - epidemiology
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Summary:Health care expenses in the United States are increasing inexorably. At the current rate of growth, it is anticipated that 20% of the gross national product will consist of health-related expenditures within the next decade. Cancer is the second leading cause of death in the United States, and it is increasing in prevalence because of the aging of the population and the limited number of successful prevention strategies. As the biological characteristics of cancer come into sharper focus, targeted therapies are being developed that offer the promise of increased clinical benefit with fewer toxicities than are associated with conventional treatment. Although spectacular successes are infrequent with this approach, to date, the majority of targeted therapies are modestly effective at best, and extremely costly. This observation suggests that a broadly acceptable definition of value in a cancer therapeutic agent is not at hand, but is sorely needed from the vantage points of the patient and society. A corollary issue of enormous import is how to equitably distribute the health care dollar in the service of achieving the greatest good for the greatest number. Although cancer is responsible for only 5% of the health care budget, its cost is increasing and it can be viewed as paradigmatic when contemplating the problem of equity in health care. Here, a number of concepts are discussed that focus on this goal and its implications for the cancer patient and society at large.
ISSN:1078-0432
1557-3265
DOI:10.1158/1078-0432.ccr-10-1643