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Experts Weigh in on Controversial Issue of Determining Value of Cancer Care at NCCN Conference
Date:3/16/2009

brings to the patient."

Dr. Fendrick noted that leaving the decision up to the physician and patient creates a classic economic dilemma, as physician and patient are making decisions on how "someone else's money" will be spent. Ms. Zonakis agreed with this assessment, adding that patients and their families would perhaps weigh treatment decisions differently if costs and benefits for various treatments were known and considered.

Dr. Gottlieb noted that "we're really talking about price," rather than discussing the possibility of a national entity that would define value. "This environment is the only one where a product's usefulness increases over time and the price doesn't change," said Dr. Gottlieb, describing how prices for drugs and biologics do not increase over time even if new and proven benefits of these agents can be demonstrated.

Dr. Goodman then posed the question: "How much are we willing to spend for a year of life?" This question echoed discussions among the panelists regarding how other countries have addressed health care value.

Dr. Newcomer recognized that this would be a difficult decision to make, and not one that can be determined at anything less than a societal level. He cited the increasing pressure on society to control health care costs, describing how he currently learns of at least four $1 million cancer cases each week, a number that would have been unheard of five years ago.

Dr. Newcomer also expressed that individuals are being forced into an increasingly worsening trade-off in purchasing health care coverage. He described rising costs of coverage over a 30-year span: in 1970, a minimum wage worker needed to spend 15% of his income to purchase a healthcare plan. In 2005, that same worker would need to spend 102% of his income for healthcare insurance. Dr. Newcomer predicted that the next economic collapse in the United States could originate in heal
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SOURCE National Comprehensive Cancer Network
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