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Is the price Americans pay for cancer treatment worth the results?

April 09, 2012|By Eryn Brown, Los Angeles Times / For the Booster Shots blog
  • Cancer treatment is much pricier in the U.S. than in Europe, but there may be a benefit: American patients live longer post-diagnosis. A new study in Health Affairs crunches the numbers to determine if the added expense is "worth it."
Cancer treatment is much pricier in the U.S. than in Europe, but there may… (EPA/BAGUS INDAHONO )

Healthcare in the United States has a reputation for being pricier than care in other countries.  But is it worth the extra expense?

A new analysis suggests that the answer may be yes, at least when it comes to cancer care.  Americans may pay more for cancer treatment, but they also live longer after diagnosis — getting a benefit that offsets their higher health expenses.

“We found that the value of the survival gains greatly outweighed the costs, which suggests that the costs of cancer care were indeed “worth it,” wrote University of Chicago public policy researcher Tomas Philipson and colleagues, in a paper published Monday by the journal Health Affairs (subscription required.)

To examine whether the higher costs were “worth it,” Philipson and his team mined extensive databases to compare cancer treatment costs and cancer survival data in the U.S. with those in 10 countries that represend 36% of the population of the European Union: Finland, France, Germany, Iceland, Norway, Slovakia, Slovenia and Sweden, as well as Scotland and Wales, which are part of the United Kingdom.  

First, the team examined the costs — and found that Americans spend much more on cancer care than Europeans, with U.S. spending increasing 49%, from $47,000 per case to $70,000 per case (in 2010 dollars,) between 1983 and 1999.  In the European countries, spending grew 16% over the same period, from $38,000 to $44,000. 

Then they looked at survival data for patients with types of cancer, including breast, prostate, colorectal and blood cancers, among others.  Comparing length of time from diagnosis to death, as well as differences in survival gains over time, they discovered that among patients diagnosed from 1995 to 1999, average survival in the U.S was 11.1 years and in the European countries studied was 9.3 years. 

Finally, the team used a standard method to put a “conservative” monetary value on the extra longevity of $150,000 per year.  Crunching all the numbers, they found that the extra years Americans enjoyed amounted to $598 billion worth of benefit over the period studied — about $61,000, on average, per patient.

“A key question for policy makers is whether the U.S. survival gains are actually produced by higher U.S. spending on cancer care or by some other factor unrelated to the healthcare delivery system,” the team wrote, cautioning that the analysis does not prove that all treatments are cost-effective.   

One influencing factor might be the faster adoption of new technologies in the U.S., the authors wrote. Their paper was accompanied by several more articles exploring the costs and benefits of U.S. cancer care.


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