Critics pounce
Experts cite old data, metrics in cancer costs study
Amid worries over ballooning healthcare costs and inferior care, a study argues that the nation’s high levels of cancer spending actually lead to better outcomes for U.S. patients when compared with their European counterparts.
Experts in cancer and healthcare spending, however, were quick to find flaw with the study, criticizing the researchers’ choice of metrics and their reliance on older data.
“I find it to be pretty difficult to understand,” Martin Brown, a health economist and chief of the National Cancer Institute’s Health Services and Economics Branch, said of the article. “There seems to be a
VIDEO lot of stuff going on in the background and a lot of assumptions being made.” For the study, which appeared in the April issue of Health Affairs, researchers from the University of Chicago and the University of Southern California used cancer registry data spanning from 1983 through 1999 to estimate cancer survival rates. Using dollar value estimates of additional years of life, they then calculated whether the additional life expectancy of American patients was worth the extra money—$72.1 billion in 2004—that is spent on cancer care in the U.S.
“Using conservative market estimates of the value of a statistical life, this study presented evidence that U.S. cancer survival gains are worth more than the corresponding growth in the cost of U.S. cancer care according to the most recent data available for analysis, 198399,” wrote the authors, who were led by Tomas Philipson, a public policy professor at the University of Chicago and a visiting scholar at the American Enterprise Institute.
But Brown, who authored one of the data sources cited in the study, argues there are other, more current sources of information available. Many of the most expensive cancer treatments in use have emerged since 1999, he says, and the study does not take those into account.
Survival rates, or the time from diagnosis until death, are a metric that most epidemiologists deem to be an inappropriate measure of outcomes, Brown added. That’s especially true because the U.S. has dramatically increased rates of screening for many types of cancer, which has improved early detection and therefore likely introduced “lead-time bias,” he said.
“It’s a very complex thing they’re trying to do and I think they have started, but there are a lot of questions that still need to be looked at,” he said. “And an update with more contemporary data would be of great interest.”