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

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

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