Cost Differential of Chemotherapy for Solid Tumors. J Oncol Pract 2016 Mar;12(3):e299-307, 251
Date
02/11/2016Pubmed ID
26860586DOI
10.1200/JOP.2015.006700Scopus ID
2-s2.0-84962480978 (requires institutional sign-in at Scopus site) 11 CitationsAbstract
PURPOSE: A significant portion of national cancer expenditure is attributed to chemotherapy.Although the National Comprehensive Cancer Network has generated recommendations for the treatment of various solid tumors, the outlined chemotherapeutic strategies lack information about the cost differential for increasing effectiveness.
METHODS: Chemotherapy regimens (curative [adjuvant/neoadjuvant] and metastatic therapy) and dosages outlined in the 2013 National Comprehensive Cancer Network guidelines were acquired for four common cancers: bladder, breast, colon, and lung. Baseline drug and treatment costs (in US dollars)were calculated for the average US adult male on the basis of the payment allowance in the 2013 Medicare Part B average sales price (ASP) drug pricing files. Costs were extrapolated for a treatment period of 6 months.
RESULTS: Of the 62 regimens included, the 6-month mean cost of chemotherapy was $26,989 ± $29,971, and the median cost was $9,611 (interquartile range, $6,305-$39,383). The mean cost of metastatic cancer therapy regimens (n = 32) was $35,315 ± 32,962 compared with $18,107 ± 23,873 for curative therapy (P = .02). Of the 13 regimens with biologics used, the mean costs were $77,278 versus $13,646 for 49 regimens that did not use biologics (P<.001). The cost differential between extremes of costs for regimens with presumed similar efficacy was $90,843 ($79,165 for curative therapy and $90,210 for metastatic cancer therapy). The highest cost differential was noted in breast cancer regimens at $71,041 for metastatic cancer therapy and $63,926 for curative therapy.
CONCLUSION: A significant cost differential exists between chemotherapeutic regimens for the most common solid tumors. Incorporation of costs and incremental effectiveness in current guidelines may encourage socially responsible practice patterns.
Author List
Nadeem H, Jayakrishnan TT, Rajeev R, Johnston FM, Gamblin TC, Turaga KKAuthor
Thomas Clark Gamblin MD Professor in the Surgery department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdultAntineoplastic Combined Chemotherapy Protocols
Breast Neoplasms
Colonic Neoplasms
Cost-Benefit Analysis
Drug Costs
Female
Humans
Lung Neoplasms
Male
United States
Urinary Bladder Neoplasms
