Can Treatment Costs Be Tamed?

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Science  25 Mar 2011:
Vol. 331, Issue 6024, pp. 1545-1547
DOI: 10.1126/science.331.6024.1545

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Over the past 3 decades, total U.S. spending on cancer care has more than quadrupled, reaching $125 billion last year, or 5% of the nation's medical bill, according to a recent estimate. By 2020, it could grow by as much as 66%, to $207 billion. Multiple forces are driving the spiral: a growing and aging population, more people living longer with cancer, and new "personalized," or "targeted," therapies that can come with sticker-shock prices of $50,000 or more per patient. New and more costly, however, haven't necessarily meant better. Although targeted treatments have helped improve survival rates for many cancers, some extend life for just a few weeks or months (see p. 1542). And the prices can be sobering: more than $1.2 million to extend a lung cancer patient's life for 1 year in one scenario involving a costly but common drug. That example is unusual, but such numbers have sparked a growing—and sometimes feisty—debate over how best to calculate the benefits of new cancer treatments, whether their use will lower or raise per-patient expenses, and who should decide whether using them is worth the cost.

  • * David Malakoff is a writer in Alexandria, Virginia.