Redefining Value in Cancer Care
The Schaeffer Center is redefining value in cancer care through ongoing research examining new methods and approaches for thinking about serious illness. Schaeffer experts provide insights to public and private-sector leaders on new payment models to increase access to innovative – and expensive – cures.
Schaeffer work linking cost to outcomes has been widely cited, including by the Economic Report(s) of the President in 2013 and 2018. When the first cancer gene therapy was released, Center experts Dana Goldman and David Agus penned an opinion piece in Fortune on the need for innovative, value-based pricing models to ensure access to breakthrough therapies that come with a high price tag. A pivotal 2012 study found the U.S. had higher cancer care cost and greater survival gains than European counterparts.
Quantifying Gains in the War on Cancer Due to Improved Treatment and Earlier Detection
Schaeffer experts – including Seth Seabury, Dana Goldman, Amitabh Chandra, Darius Lakdawalla, and colleagues – found that improved treatment options and better early detection have led to significant survival gains for cancer patients diagnosed from 1997 to 2007, generating considerable social value over this time period.
Although significant improvements in treatment and screening efforts have been developed for many types of cancer over the past decade, the effects of these advancements on the survival of cancer patients has been unknown. Using a retrospective analysis of SEER Registry data to quantify reductions in mortality rates for cancer patients diagnosed between 1997 and 2007, the researchers estimate that three-year, cancer-related mortality of patients fell 16.7% from 1997 to 2007. Overall, advances in treatment reduced mortality rates by approximately 12.2% while advances in early detection reduced mortality rates by 4.5%.
The relative importance of treatment and detection varied across cancer types. Improvements in detection were most important for thyroid, prostate and kidney cancer. Improvements in treatment were most important for non-Hodgkins lymphoma, lung cancer and myeloma.
The full study is available at Forum for Health Economics and Policy.
Five Myths About Cancer Care
Schaeffer Center Director Dana Goldman penned an op-ed in Health Affairs with Tomas Philipson, Daniel Levin Professor of Public Policy, Economics, and Law at the University of Chicago, in Illinois, on the biggest misconceptions about the evolution of cancer care over the past several decades.
Goldman and Philipson contend that editorials stating the ‘war on cancer’ has been a failure reflect beliefs that arose years ago when the illnesses were not as well understood. They highlight that the consequence of reinforcing these myths about cancer care draws the public’s attention away from the real story: the breakthroughs that have occurred in recent decades and the resulting value to survivors.
Their insight is continually cited in major journals including, Cancer, Health Affairs, and Leukemia.
Issues in Cancer Care: Value, Costs and Quality
Schaeffer Center scholars authored a cluster of articles published in a special 2012 issue of Health Affairs titled “Issues in Cancer Care: Value, Costs and Quality,” which provided a closer look at how much healthy people and cancer patients value treatment and hope. Taken together, the articles probed additional considerations for policymakers, patients, providers and others as to when a high-cost treatment is “worth” the price.
One analysis led by Darius Lakdawalla, director of research at the Schaeffer Center, surveyed 150 cancer patients currently undergoing treatment. Lakdawalla and his co-authors found the overwhelming majority of cancer patients prefer riskier treatments that offer the possibility of longer survival over safer treatment.
Value should be defined from the viewpoint of the patient.
Healthy people are willing to pay more for generous coverage of high-cost drugs that treat cancer and other serious diseases, according to research led by John Romley. Seth Seabury and Dana Goldman also evaluated how highly patients value metastatic cancer therapy.