Navigation Links
Penn medicine study finds broad support for rationing of some types of cancer care
Date:5/15/2013

PHILADELPHIA The majority of cancer doctors, patients, and members of the general public support cutting health care costs by refusing to pay for drugs that don't improve survival or quality of life, according to results of a new study that will be presented by researchers from the Perelman School of Medicine at the University of Pennsylvania during the annual meeting of the American Society of Clinical Oncology in Chicago in early June (Abstract #6518).

The Penn Medicine team surveyed 326 adult cancer patients receiving treatment at Penn's Abramson Cancer Center, a random sample of 891 adults in the general public, and 250 oncologists across the United States during 2012 to probe their opinions about tactics for controlling costs associated with cancer care.

"We found that the majority of respondents considered Medicare spending a big or moderate problem, and many suggested that Medicare could spend less without causing harm," said the study's lead author, Keerthi Gogineni, MD, MSHP, an instructor in the division of Hematology-Oncology in Penn's Abramson Cancer Center. "We know that cancer patients and their doctors face decisions every day that stand to raise health care costs without conferring much benefit to patients, and our survey has identified some common themes in how these groups of stakeholders might propose to lower costs of care while still protecting patients."

More than 90 percent of all three groups surveyed attributed rising costs to drug companies charging too much, and more than 80 percent of each group cited insurance company profits as a driver of rising costs. Many also thought hospitals and doctors conducted unnecessary tests and provided unnecessary treatments (69 percent of patients, 81 percent of the general public, and 70 percent of doctors).

The research team, which includes senior author Ezekiel J. Emanuel, MD, PhD, chairman of the department of Medical Ethics and Health Policy, presented a variety of potential cost-lowering options to each group and asked whether they supported the idea. Cancer patients, members of the general public, and oncologists tended to be about as likely to say patients who can afford to pay more for care should be asked to pay more (56, 58, and 52 percent, respectively). And large numbers favored not paying for more expensive drugs when cheaper alternatives are equally as effective (78 percent of patients, 86 percent of the general public, and 90 percent of physicians). The majority also supported refusing to cover drugs that do not improve survival or quality of life, though physicians were more apt to refuse payment under those circumstances (79 percent compared to 52 percent of patients and 57 percent of the general public).

Even drugs that confer only incremental gains in survival, however, were found to be worth covering in the eyes of all groups surveyed: Just 12 percent of physicians were willing to refuse payment for a drug that extends life by four months, compared to 20 percent of patients and 28 percent of the general public.

Greater differences of opinion were observed around coverage for drugs offering benefits other than survival gains. When queried about a drug that doesn't extend life but reduces pain, for instance, only 5 percent of patients and 10 percent of the general public voiced support for refusing to cover the medication, compared to 32 percent of physicians. On coverage for a drug that doesn't extend life but adds convenience, 27 and 32 percent of patients and the general public, respectively, said those costs should not be covered, compared to 59 percent of physicians.

"These results suggest that patients and the lay public prioritize quality of life, while oncologists appear focused on controlling disease and increasing length of life," Gogineni says. "Patients have a much broader set of concerns, from the cost of their doctor's visits to the side effects of treatment and the emotional toll of their illness."

Sixty four percent of physicians said they supported the idea of an independent expert panel that would decide which therapies to cover, but that plan was met with resistance from patients (33 percent approved) and the general public (46 percent approved). The authors suggest this may be because physicians are more familiar with such models, which are already used for decision-making around scarce medical resources such as ICU beds and organs for transplantation. And, Gogineni notes, "distancing the locus of responsibility for access to high cost, low benefit cancer treatment may create less strain on the physician-patient relationship."

Gogineni will present the team's findings at ASCO on Sunday, June 2, 2013 in the Health Services Research poster session from 8 a.m. to noon in McCormick Place S405.


'/>"/>

Contact: Holly Auer
holly.auer@uphs.upenn.edu
215-200-2313
University of Pennsylvania School of Medicine
Source:Eurekalert

Related medicine news :

1. Icahn School of Medicine at Mount Sinai and Bene Pharmachem Gmbh to Collaborate on Clinical Studies for Mucopolysaccaridoses
2. Alternative Wellness Center Provides Bellevue, Washington With Botanical Medicine
3. Queens scientists develop magic bullet nanomedicine for Acute Lung Injury
4. IU School of Medicine Breast Cancer Experts Available for Comment on Angelina Jolie Decision
5. Icahn School of Medicine at Mount Sinai Honors Innovators in Scientific Research and Health Care Philanthropy at 2013 Commencement Ceremony
6. Dr. Augustine M. K. Choi Appointed Chairman of Medicine at Weill Cornell Medical College and Physician-in-Chief at NewYork-Presbyterian/Weill Cornell Medical Center
7. DMG Productions Announces New Episode of Business Update, Focusing on Technology and Medicine
8. Health First and Palm Bay Police Department Receive National Recognition for Innovative Telemedicine Project to Help Patients Before they Get to the Hospital
9. SAGE and AOSSM launch the Orthopaedic Journal of Sports Medicine
10. CWRU School of Medicine researchers discover new target for personalized cancer therapy
11. Northwestern Medicine researchers work to improve heart attack response time
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:2/6/2016)... ... 2016 , ... With the FCPX LUT: Summer pack from Pixel ... A LUT is a Lookup Table that contains a mathematical formula for modifying an ... table. By manipulating each pixel, LUT's can change each color range differently, it gives ...
(Date:2/5/2016)... ... ... Love is in the air at King Kullen! The local grocer is offering ... for Valentine’s Day is a must-have, and can be picked up with all other ... long-stem roses available, but also other flower bouquets, elegantly wrapped and ready to go. ...
(Date:2/5/2016)... ... February 05, 2016 , ... The event is being held ... Event Center in Minneapolis, Minn. Triumph Over Parkinson’s will fund nearly $100,000 for research ... Schneiderman’s Furniture, lives with Parkinson’s disease and is the architect of this informative event ...
(Date:2/5/2016)... ... February 05, 2016 , ... Freed-Hardeman University ... Allen have signed a joint enrollment and degree completion agreement. The agreement, ... and baccalaureate degrees at FHU|Dickson. , The agreement allows students to be ...
(Date:2/5/2016)... ... February 05, 2016 , ... ... franchises from across the country gathered at the La Valencia Hotel in San ... PROSHRED Chicago was named the year’s most outstanding franchise, walking away with ...
Breaking Medicine News(10 mins):
(Date:2/4/2016)... Mettler-Toledo International Inc. (NYSE: MTD ) today announced ... highlights: , Sales in local currency increased ... Reported sales decreased 3% as currency reduced sales growth ... per diluted share as reported (EPS) were $4.44, compared ... was $4.65, an increase of 10% over the prior-year ...
(Date:2/4/2016)... Md. , Feb. 4, 2016 In response ... , the FDA,s Deputy Commissioner for Medical Products and Tobacco, ... plan to reassess the agency,s approach to opioid medications. The ... while still providing patients in pain access to effective relief. ... FDA will: , Re-examine the risk-benefit paradigm for ...
(Date:2/4/2016)... 2016  Blueprint Medicines Corporation (NASDAQ: BPMC ... selective investigational kinase medicines for patients with genomically ... board of directors of Lonnel Coats , ... of industry-related experience. Jeffrey Albers ... strong strategic experience developing and commercializing numerous oncology ...
Breaking Medicine Technology: