Evidence-based medicine and cancer treatment

A new article looks at how evidence-based medicine can help reduce the cost of cancer treatment. Here’s the situation:

The high cost of oncology is gaining a lot of attention these days. With cancer care accounting for ten percent of healthcare costs, payers are hungry to find ways to be more frugal. As oncologists, it is in our best interest, as well as the best interest of our patients, to take a proactive, leadership role in finding solutions that sustain our ability to deliver high-quality care.

OK, sounds good. How do we accomplish this? One idea:

A study by Milliman analyzing Medstat 2007 data revealed that out of those chemotherapy patients with 10 major cancer diagnoses who were identified as dying in an inpatient setting, 24% received chemotherapy within 14 days of death and 51% received chemotherapy within 30 days of death. While we cannot always predict when death will occur, pathways can help guide physicians in making decisions and treatment recommendations pertaining to whether to offer additional cycles of a treatment or move to second, third, and further lines of treatment. They can also provide practical guidance that can be helpful in end-of-life care discussions. This includes demonstrating that transitioning to hospice care can improve the patient’s and the family’s quality of life and can reduce the costs borne by the family and payers by avoiding unnecessary and ineffective chemotherapy administered within a few weeks of death.

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