Delivering affordable cancer care in high-income countries

Richard Sullivan, Jeffrey Peppercorn, Karol Sikora, John Zalcberg, Neal J Meropol, Eitan Amir, David Khayat, Peter Boyle, Philippe Autier, Ian F Tannock, Tito Fojo, Jim Siderov, Steve Williamson, Silvia Camporesi, J Gordon McVie, Arnie D Purushotham, Peter Naredi, Alexander Eggermont, Murray F Brennan, Michael L Steinberg & 17 others Mark De Ridder, Susan A McCloskey, Dirk Verellen, Terence Roberts, Guy Storme, Rodney J Hicks, Peter J Ell, Bradford R Hirsch, David P Carbone, Kevin A Schulman, Paul Catchpole, David Taylor, Jan Geissler, Nancy G Brinker, David Meltzer, David Kerr, Matti Aapro

Research output: Contribution to journalArticle

440 Citations (Scopus)

Abstract

The burden of cancer is growing, and the disease is becoming a major economic expenditure for all developed countries. In 2008, the worldwide cost of cancer due to premature death and disability (not including direct medical costs) was estimated to be US$895 billion. This is not simply due to an increase in absolute numbers, but also the rate of increase of expenditure on cancer. What are the drivers and solutions to the so-called cancer-cost curve in developed countries? How are we going to afford to deliver high quality and equitable care? Here, expert opinion from health-care professionals, policy makers, and cancer survivors has been gathered to address the barriers and solutions to delivering affordable cancer care. Although many of the drivers and themes are specific to a particular field-eg, the huge development costs for cancer medicines-there is strong concordance running through each contribution. Several drivers of cost, such as over-use, rapid expansion, and shortening life cycles of cancer technologies (such as medicines and imaging modalities), and the lack of suitable clinical research and integrated health economic studies, have converged with more defensive medical practice, a less informed regulatory system, a lack of evidence-based sociopolitical debate, and a declining degree of fairness for all patients with cancer. Urgent solutions range from re-engineering of the macroeconomic basis of cancer costs (eg, value-based approaches to bend the cost curve and allow cost-saving technologies), greater education of policy makers, and an informed and transparent regulatory system. A radical shift in cancer policy is also required. Political toleration of unfairness in access to affordable cancer treatment is unacceptable. The cancer profession and industry should take responsibility and not accept a substandard evidence base and an ethos of very small benefit at whatever cost; rather, we need delivery of fair prices and real value from new technologies.
Original languageEnglish
Pages (from-to)933-980
Number of pages48
JournalLancet Oncology
Volume12
Issue number10
DOIs
Publication statusPublished - Sep 2011

Fingerprint

Costs and Cost Analysis
Costs
Neoplasms
Medicine
Health Expenditures
Technology
Administrative Personnel
Developed Countries
Economics
Oncology
Defensive Medicine
Health care
Life cycle
Premature Mortality
Quality of Health Care
Education
Expert Testimony
Health
Life Cycle Stages
Imaging techniques

Keywords

  • united states
  • health services misuse
  • health expenditures
  • humans
  • health services research
  • europe
  • health policy
  • cost savings
  • health services accessibility
  • models, economic
  • health care costs
  • socioeconomic factors
  • neoplasms
  • health care reform
  • cost-benefit analysis
  • insurance, health
  • australia
  • delivery of health care, integrated
  • healthcare disparities

Cite this

Sullivan, R., Peppercorn, J., Sikora, K., Zalcberg, J., Meropol, N. J., Amir, E., ... Aapro, M. (2011). Delivering affordable cancer care in high-income countries. Lancet Oncology, 12(10), 933-980. https://doi.org/10.1016/S1470-2045(11)70141-3
Sullivan, Richard ; Peppercorn, Jeffrey ; Sikora, Karol ; Zalcberg, John ; Meropol, Neal J ; Amir, Eitan ; Khayat, David ; Boyle, Peter ; Autier, Philippe ; Tannock, Ian F ; Fojo, Tito ; Siderov, Jim ; Williamson, Steve ; Camporesi, Silvia ; McVie, J Gordon ; Purushotham, Arnie D ; Naredi, Peter ; Eggermont, Alexander ; Brennan, Murray F ; Steinberg, Michael L ; De Ridder, Mark ; McCloskey, Susan A ; Verellen, Dirk ; Roberts, Terence ; Storme, Guy ; Hicks, Rodney J ; Ell, Peter J ; Hirsch, Bradford R ; Carbone, David P ; Schulman, Kevin A ; Catchpole, Paul ; Taylor, David ; Geissler, Jan ; Brinker, Nancy G ; Meltzer, David ; Kerr, David ; Aapro, Matti. / Delivering affordable cancer care in high-income countries. In: Lancet Oncology. 2011 ; Vol. 12, No. 10. pp. 933-980.
@article{b4f4a59c5e764e30833f389c6d3a58b9,
title = "Delivering affordable cancer care in high-income countries",
abstract = "The burden of cancer is growing, and the disease is becoming a major economic expenditure for all developed countries. In 2008, the worldwide cost of cancer due to premature death and disability (not including direct medical costs) was estimated to be US$895 billion. This is not simply due to an increase in absolute numbers, but also the rate of increase of expenditure on cancer. What are the drivers and solutions to the so-called cancer-cost curve in developed countries? How are we going to afford to deliver high quality and equitable care? Here, expert opinion from health-care professionals, policy makers, and cancer survivors has been gathered to address the barriers and solutions to delivering affordable cancer care. Although many of the drivers and themes are specific to a particular field-eg, the huge development costs for cancer medicines-there is strong concordance running through each contribution. Several drivers of cost, such as over-use, rapid expansion, and shortening life cycles of cancer technologies (such as medicines and imaging modalities), and the lack of suitable clinical research and integrated health economic studies, have converged with more defensive medical practice, a less informed regulatory system, a lack of evidence-based sociopolitical debate, and a declining degree of fairness for all patients with cancer. Urgent solutions range from re-engineering of the macroeconomic basis of cancer costs (eg, value-based approaches to bend the cost curve and allow cost-saving technologies), greater education of policy makers, and an informed and transparent regulatory system. A radical shift in cancer policy is also required. Political toleration of unfairness in access to affordable cancer treatment is unacceptable. The cancer profession and industry should take responsibility and not accept a substandard evidence base and an ethos of very small benefit at whatever cost; rather, we need delivery of fair prices and real value from new technologies.",
keywords = "united states, health services misuse, health expenditures, humans, health services research, europe, health policy, cost savings, health services accessibility, models, economic, health care costs, socioeconomic factors, neoplasms, health care reform, cost-benefit analysis, insurance, health, australia, delivery of health care, integrated, healthcare disparities",
author = "Richard Sullivan and Jeffrey Peppercorn and Karol Sikora and John Zalcberg and Meropol, {Neal J} and Eitan Amir and David Khayat and Peter Boyle and Philippe Autier and Tannock, {Ian F} and Tito Fojo and Jim Siderov and Steve Williamson and Silvia Camporesi and McVie, {J Gordon} and Purushotham, {Arnie D} and Peter Naredi and Alexander Eggermont and Brennan, {Murray F} and Steinberg, {Michael L} and {De Ridder}, Mark and McCloskey, {Susan A} and Dirk Verellen and Terence Roberts and Guy Storme and Hicks, {Rodney J} and Ell, {Peter J} and Hirsch, {Bradford R} and Carbone, {David P} and Schulman, {Kevin A} and Paul Catchpole and David Taylor and Jan Geissler and Brinker, {Nancy G} and David Meltzer and David Kerr and Matti Aapro",
year = "2011",
month = "9",
doi = "10.1016/S1470-2045(11)70141-3",
language = "English",
volume = "12",
pages = "933--980",
journal = "Lancet Oncology",
issn = "1470-2045",
number = "10",

}

Sullivan, R, Peppercorn, J, Sikora, K, Zalcberg, J, Meropol, NJ, Amir, E, Khayat, D, Boyle, P, Autier, P, Tannock, IF, Fojo, T, Siderov, J, Williamson, S, Camporesi, S, McVie, JG, Purushotham, AD, Naredi, P, Eggermont, A, Brennan, MF, Steinberg, ML, De Ridder, M, McCloskey, SA, Verellen, D, Roberts, T, Storme, G, Hicks, RJ, Ell, PJ, Hirsch, BR, Carbone, DP, Schulman, KA, Catchpole, P, Taylor, D, Geissler, J, Brinker, NG, Meltzer, D, Kerr, D & Aapro, M 2011, 'Delivering affordable cancer care in high-income countries', Lancet Oncology, vol. 12, no. 10, pp. 933-980. https://doi.org/10.1016/S1470-2045(11)70141-3

Delivering affordable cancer care in high-income countries. / Sullivan, Richard; Peppercorn, Jeffrey; Sikora, Karol; Zalcberg, John; Meropol, Neal J; Amir, Eitan; Khayat, David; Boyle, Peter; Autier, Philippe; Tannock, Ian F; Fojo, Tito; Siderov, Jim; Williamson, Steve; Camporesi, Silvia; McVie, J Gordon; Purushotham, Arnie D; Naredi, Peter; Eggermont, Alexander; Brennan, Murray F; Steinberg, Michael L; De Ridder, Mark; McCloskey, Susan A; Verellen, Dirk; Roberts, Terence; Storme, Guy; Hicks, Rodney J; Ell, Peter J; Hirsch, Bradford R; Carbone, David P; Schulman, Kevin A; Catchpole, Paul; Taylor, David; Geissler, Jan; Brinker, Nancy G; Meltzer, David; Kerr, David; Aapro, Matti.

In: Lancet Oncology, Vol. 12, No. 10, 09.2011, p. 933-980.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Delivering affordable cancer care in high-income countries

AU - Sullivan, Richard

AU - Peppercorn, Jeffrey

AU - Sikora, Karol

AU - Zalcberg, John

AU - Meropol, Neal J

AU - Amir, Eitan

AU - Khayat, David

AU - Boyle, Peter

AU - Autier, Philippe

AU - Tannock, Ian F

AU - Fojo, Tito

AU - Siderov, Jim

AU - Williamson, Steve

AU - Camporesi, Silvia

AU - McVie, J Gordon

AU - Purushotham, Arnie D

AU - Naredi, Peter

AU - Eggermont, Alexander

AU - Brennan, Murray F

AU - Steinberg, Michael L

AU - De Ridder, Mark

AU - McCloskey, Susan A

AU - Verellen, Dirk

AU - Roberts, Terence

AU - Storme, Guy

AU - Hicks, Rodney J

AU - Ell, Peter J

AU - Hirsch, Bradford R

AU - Carbone, David P

AU - Schulman, Kevin A

AU - Catchpole, Paul

AU - Taylor, David

AU - Geissler, Jan

AU - Brinker, Nancy G

AU - Meltzer, David

AU - Kerr, David

AU - Aapro, Matti

PY - 2011/9

Y1 - 2011/9

N2 - The burden of cancer is growing, and the disease is becoming a major economic expenditure for all developed countries. In 2008, the worldwide cost of cancer due to premature death and disability (not including direct medical costs) was estimated to be US$895 billion. This is not simply due to an increase in absolute numbers, but also the rate of increase of expenditure on cancer. What are the drivers and solutions to the so-called cancer-cost curve in developed countries? How are we going to afford to deliver high quality and equitable care? Here, expert opinion from health-care professionals, policy makers, and cancer survivors has been gathered to address the barriers and solutions to delivering affordable cancer care. Although many of the drivers and themes are specific to a particular field-eg, the huge development costs for cancer medicines-there is strong concordance running through each contribution. Several drivers of cost, such as over-use, rapid expansion, and shortening life cycles of cancer technologies (such as medicines and imaging modalities), and the lack of suitable clinical research and integrated health economic studies, have converged with more defensive medical practice, a less informed regulatory system, a lack of evidence-based sociopolitical debate, and a declining degree of fairness for all patients with cancer. Urgent solutions range from re-engineering of the macroeconomic basis of cancer costs (eg, value-based approaches to bend the cost curve and allow cost-saving technologies), greater education of policy makers, and an informed and transparent regulatory system. A radical shift in cancer policy is also required. Political toleration of unfairness in access to affordable cancer treatment is unacceptable. The cancer profession and industry should take responsibility and not accept a substandard evidence base and an ethos of very small benefit at whatever cost; rather, we need delivery of fair prices and real value from new technologies.

AB - The burden of cancer is growing, and the disease is becoming a major economic expenditure for all developed countries. In 2008, the worldwide cost of cancer due to premature death and disability (not including direct medical costs) was estimated to be US$895 billion. This is not simply due to an increase in absolute numbers, but also the rate of increase of expenditure on cancer. What are the drivers and solutions to the so-called cancer-cost curve in developed countries? How are we going to afford to deliver high quality and equitable care? Here, expert opinion from health-care professionals, policy makers, and cancer survivors has been gathered to address the barriers and solutions to delivering affordable cancer care. Although many of the drivers and themes are specific to a particular field-eg, the huge development costs for cancer medicines-there is strong concordance running through each contribution. Several drivers of cost, such as over-use, rapid expansion, and shortening life cycles of cancer technologies (such as medicines and imaging modalities), and the lack of suitable clinical research and integrated health economic studies, have converged with more defensive medical practice, a less informed regulatory system, a lack of evidence-based sociopolitical debate, and a declining degree of fairness for all patients with cancer. Urgent solutions range from re-engineering of the macroeconomic basis of cancer costs (eg, value-based approaches to bend the cost curve and allow cost-saving technologies), greater education of policy makers, and an informed and transparent regulatory system. A radical shift in cancer policy is also required. Political toleration of unfairness in access to affordable cancer treatment is unacceptable. The cancer profession and industry should take responsibility and not accept a substandard evidence base and an ethos of very small benefit at whatever cost; rather, we need delivery of fair prices and real value from new technologies.

KW - united states

KW - health services misuse

KW - health expenditures

KW - humans

KW - health services research

KW - europe

KW - health policy

KW - cost savings

KW - health services accessibility

KW - models, economic

KW - health care costs

KW - socioeconomic factors

KW - neoplasms

KW - health care reform

KW - cost-benefit analysis

KW - insurance, health

KW - australia

KW - delivery of health care, integrated

KW - healthcare disparities

UR - http://www.journals.elsevier.com/the-lancet-oncology

U2 - 10.1016/S1470-2045(11)70141-3

DO - 10.1016/S1470-2045(11)70141-3

M3 - Article

VL - 12

SP - 933

EP - 980

JO - Lancet Oncology

JF - Lancet Oncology

SN - 1470-2045

IS - 10

ER -

Sullivan R, Peppercorn J, Sikora K, Zalcberg J, Meropol NJ, Amir E et al. Delivering affordable cancer care in high-income countries. Lancet Oncology. 2011 Sep;12(10):933-980. https://doi.org/10.1016/S1470-2045(11)70141-3