Unbiased Analysis of Today's Healthcare Issues
It appears that the answer is ‘yes’. Many studies by the Dartmouth Atlas team have shown that regions that spend more on medical care do not always get better outcomes. However, a recent paper by my Precision Health Economics colleagues James Baumgardner, Ahva Shahabi, Mark Linthicum, Seanna Vine, and Darius Lakdawalla as well as Chris Zacker…
Let’s get this out of the way: both are clearly important. Within appropriate screening, patients don’t get the treatment they need. Further, delayed screening can make treatments less effective if the cancer has progressed or metastasized. On the other hand, without effective treatment, screening won’t have a major impact on patient outcomes. The question is,…
An interesting study measuring trends in cancer survival between 2000 and 2014 found, unsurprisingly, that patients in more developed countries had better survival. For women diagnosed with breast cancer between 2010 and 2014, 5-year survival rates reached 89.5% in Australia and 90.2% in the United States, but generally varied worldwide and remained low in some…
Along with my co-authors Jeff Sullivan, Jacki Chou, Michael Neely, Justin Doan, and Ross Maclean I am happy to announce to publication our paper “The effect of medication nonadherence on progression-free survival among patients with renal cell carcinoma” in Cancer Management and Research. The abstract is below. Objective: To examine how observed medication nonadherence to 2…
One key benefit new cancer treatments is not only that they improve survival, but also–in areas with a lot of treatment innovation–they that they allow some patients to live to receive the next treatment advance. Although this concept may make sense intuitively, it is not clear how one could quantify this value. This is the…
Clearly choosing treatments that extend expected survival is important, but survival expectations are not the only factor that matters to cancer patients. A 2017 NCCN policy report–based on the findings from a working group–identifies a number of factors: Patients, for example, may view high-value care as any combination of trust, transparency, and effective communication with…
This is the question that a recent study in BMJ by Davis et al. (2017) attempts to answer. They use data from 48 cancer drugs for 68 indications that were approved by the European Medicines Agency (EMA) between 2009 and 2013. Among these 68 indications, they found that: only 35 (51%) were associated with significant improvement…
An interesting study by Chen et al. (2017) examines the cost of cancer care among Medicare patients. Using SEER-Medicare data of people diagnosed with cancer between 2007 and 2011, they found: Over the year of diagnosis, mean per-patient annual Medicare spending varied substantially by cancer type: $35,849 for breast cancer, $26,295 for prostate cancer, $55,597…
When each drug is approved by the FDA, the drug is not approved to treat all patients. Each drug receives an “indication” which basically represents the types of patients the drug can treat. Giving the treatment to patients with said indication is known as “on label” prescribing. Drugs developed to treat one disease may sometimes…
As research in new cancer treatments has grown, scientists may have run into a serious roadblock: there many not be enough patients to fill the needed clinical trials. As the New York Times reports: There are too many experimental cancer drugs in too many clinical trials, and not enough patients to test them on. The logjam…