Report: Cancer Doctors Have Opportunities to Cut Costs Without Risk to Patients
Experts cite potential savings on end-of-life care, medical imaging, and new drug prices (February 14)
In a review article published in Lancet Oncology, Johns Hopkins experts identify three major sources of high cancer costs and argue that cancer doctors can likely reduce them without harm to patients. The cost-cutting proposals call for changes in routine clinical practice involved in end-of-life care, medical imaging, and drug pricing.
In the article, the authors say that the biggest opportunities for safe and ethical cost-cutting solutions rest on caring for patients with metastatic cancer, not on new surgical or radiation treatments, clinical trials, curative care, or pediatric care.
For example, the authors suggest that improving end-of-life care with better decision-making and planning could reap large cost savings by reducing hospitalizations in the last month of life.
According to the article, hospice care improves symptoms, helps caregivers and costs less, with equal or better survival for patients, yet only half of cancer patients use hospice in their last month of life.
They recommend that patients with poor prognoses have better and earlier discussions with their oncologists about chemotherapy use at the end of life, as well as transitions to hospice. Decision aids spanning these topics are endorsed by the American Society of Clinical Oncology.
Unneeded and expensive imaging poses another opportunity to limit costs of care, the authors say. PET and other scans, for example, are often used to detect cancer recurrence in patients after initial treatments, but studies show that cure rates are just as good when recurrences are found through other examinations.
Finally, the authors suggest that reducing prices of new cancer drugs could help contain cancer costs. One approach, they say, could be to price drugs according to how well they prolong life.
Source: EurekAlert; February 14, 2014.