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New study shows costs play role in oncologists' treatment recommendations
But most physicians do not discuss cost issues with patients-added 1/7/10
BOSTON - In the largest survey to date of U.S. oncologists' attitudes about the cost of cancer treatments, researchers at Tufts Medical Center and the University of Michigan found that 84% of oncologists consider their patients' out-of-pocket costs when recommending cancer treatment. However, fewer than half of the respondents surveyed frequently discuss cost issues with patients.
The survey, published in the January 2010 edition of Health Affairs, also found support among oncologists for comparative-effectiveness research, which could help doctors make decisions about which treatments are best for different patients. Seventy-nine percent say they support more government research into the comparative effectiveness of different cancer drugs. The findings are significant, as federal funding for this research is included as part of health reform efforts.
"Our study underscores the importance of cancer treatment costs as a reality among U.S. oncologists," says Peter Neumann, Sc.D., director of the Center for the Evaluation of Value and Risk in Health at the Institute for Clinical Research and Health Policy Studies at Tufts Medical Center and principal investigator for the study. "The lack of communication suggests that oncologists are uncomfortable with the subject and may lack accurate knowledge about the actual costs and insurance coverage of drugs."
The study also shows that oncologists would like more information about the cost-effectiveness of cancer drugs.
While new cancer treatments offer hope to patients and their families, spending on cancer medications has risen 14% annually in recent years. Treatment costs can exceed tens of thousands of dollars annually for some patients, which has led to debates about whether the costs of treatments are worth the benefits.
"Oncologists understand, from up close, that cancer diagnoses and treatments leave many people bankrupt," adds senior author Peter Ubel, M.D., professor of internal medicine and director of the Center for Behavioral and Decision Sciences in Medicine at the University of Michigan Medical School. "They want to do what is medically right for their patients, but they are struggling to figure out what, at the same time, is economically right for them."
The 2008 survey, now being published for the first time in Health Affairs, is based on responses from 787 U.S.-based oncologists and was funded by the California HealthCare Foundation, a non-profit, independent foundation committed to improving the way health care is delivered and financed.
Written by Nicole Fawcett