David H. Howard, PhD, and colleagues at Emory University’s Rollins School of Public Health (RSPH), used a cancer registry database to measure trends in life expectancy and lifetime medical costs in 4,665 patients age 66 and older diagnosed with metastatic colon cancer between 1995 and 2005. Patients were classified according to whether they received one or more of the six chemotherapeutic agents approved for the treatment of metastatic colon cancer between 1996 and 2004.
Among those who received the new agents, life expectancy increased by 6.8 months and lifetime costs increased by $37,100, equating to a cost of $66,200 per year of life gained. After additional adjustments, the cost for each quality-adjusted life year (a year of life in perfect health) gained was $99,100, says lead study author Howard, associate professor of health policy and management, RSPH.
“New chemotherapeutic agents for colorectal cancer have been singled out as examples of high-cost/low-value medical care; no doubt they are the types of therapies that would receive close scrutiny if Medicare and other payers were to consider cost-effectiveness in coverage decisions,” Howard and co-authors write.
“Our estimate of the cost per quality-adjusted life year gained, $100,000, is below most estimates of the willingness to pay for a life-year,” the authors say. “However, continuation of Medicare’s open-ended coverage policy for new chemotherapeutic agents and other expensive technologies will prove difficult to sustain as costs for the program continue to rise.”
The study, “The Value of New Chemotherapeutic Agents for Metastatic Colorectal Cancer,” is published in the March 16, 2010 issue of the Archives of Internal Medicine, a publication of the American Medical Association.
In addition to Howard, study authors were John Kauh, MD, assistant professor of hematology and medical oncology, Emory School of Medicine, and Joseph Lipscomb, PhD, professor of health policy and management, RSPH.
The Robert W. Woodruff Health Sciences Center of Emory University is an academic health science and service center focused on missions of teaching, research, health care and public service. Its components include the Emory University School of Medicine, Nell Hodgson Woodruff School of Nursing, and Rollins School of Public Health; Yerkes National Primate Research Center; Emory Winship Cancer Institute; and Emory Healthcare, the largest, most comprehensive health system in Georgia. Emory Healthcare includes: The Emory Clinic, Emory-Children’s Center, Emory University Hospital, Emory University Hospital Midtown, Wesley Woods Center, and Emory University Orthopaedics & Spine Hospital. The Woodruff Health Sciences Center has a $2.5 billion budget, 17,600 employees, 2,500 full-time and 1,500 affiliated faculty, 4,700 students and trainees, and a $5.7 billion economic impact on metro Atlanta.