Higher cancer spending linked to longer life

U.S. cancer patients spend more compared to European countries, but is it worth the extra dollars? According to new research published in the April Health Affairs, it could worth the costs, as patients live about two years longer.

Researchers compared U.S. patients to 10 European countries from 1983 through 1999 and found that for most cancers, U.S. spending soared from $47,000 to $70,000 per cancer case, while European countries' spending increased from $38,000 to only $44,000 per case, according to Kaiser Health News. Researchers also found that from 1995 to 1999, U.S. patients lived an average of 11.1 years after diagnosis, while European patients lived 9.3 years.

The value of survival gains was highest for prostate cancer patients ($627 billion) and breast cancer patients ($173 billion), according to the study.  The longer lives of U.S. patients are worth an average value of $61,000 per person, or a total $598 billion, of those diagnosed between 1983 and 1999, Kaiser Health News noted.

One reason for the increased costs may be that healthy people are willing to pay more (an extra $12.94 per month) for coverage of expensive drugs that treat cancer and other serious diseases, according to a separate study in the special issue on cancer spending in Health Affairs, led by John A. Romley, an economist with the Schaeffer Center at USC and research assistant professor at the USC Price School of Public Policy.

More than three quarters (77 percent) of cancer patients said they would rather take a "hopeful gamble"--treatments that offer a 50/50 chance of either adding three years or no additional survival--compared to "safe bets" that would keep them alive for 18 months but no longer, according to the study announcement.

The studies also bring up the question as to whether cancer care in America respects the patients' wishes and abides by clinical guidelines. When researchers looked at cancer care, comparing American hospitals, they found that care for Medicare patients at elite cancer centers was not much different than community hospitals, according to another study in the journal. Terminally ill patients receive aggressive, highly intense treatments in the final weeks of patients' lives--more so than many patients prefer-- regardless of setting.

"These results indicate the need for a broad reexamination of end-of-life cancer care and whether it meets the needs and wants of patients. We recommend that efforts to improve the quality of end-of-life care extend to every type of hospital, regardless of their designation," David C. Goodman, co-principal investigator of the Dartmouth Atlas Project and director of the Center for Health Policy Research at The Dartmouth Institute for Health Policy and Clinical Practice, said in the study announcement.

For more information:
- read the Kaiser Health News article
- see the study abstract on cancer spending
- here's the study abstract and the press release on patients' value of hope
- check out the study abstract and the statement on end-of-life care

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