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; 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

doi:10.1016/S1470-2045(11)70141-3

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 SteinbergMark 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 journal › Article › peer-review

570 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 language	English
Pages (from-to)	933-980
Number of pages	48
Journal	The Lancet Oncology
Volume	12
Issue number	10
DOIs	https://doi.org/10.1016/S1470-2045(11)70141-3
Publication status	Published - Sept 2011

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10.1016/S1470-2045(11)70141-3

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Sullivan, R., Peppercorn, J., Sikora, K., Zalcberg, J., Meropol, N. J., Amir, E., Khayat, D., Boyle, P., Autier, P., Tannock, I. F., Fojo, T., Siderov, J., Williamson, S., Camporesi, S., McVie, J. G., Purushotham, A. D., Naredi, P., Eggermont, A., Brennan, M. F., ... Aapro, M. (2011). Delivering affordable cancer care in high-income countries. The Lancet Oncology, 12(10), 933-980. https://doi.org/10.1016/S1470-2045(11)70141-3

@article{d1984ea717cd422ca51b59e442506b03,

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.",

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 = sep,

doi = "10.1016/S1470-2045(11)70141-3",

language = "English",

volume = "12",

pages = "933--980",

journal = "The Lancet Oncology",

issn = "1474-5488",

publisher = "Lancet Publishing Group",

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', The Lancet Oncology, vol. 12, no. 10, pp. 933-980. https://doi.org/10.1016/S1470-2045(11)70141-3

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.

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

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

M3 - Article

C2 - 21958503

SN - 1474-5488

VL - 12

SP - 933

EP - 980

JO - The Lancet Oncology

JF - The Lancet Oncology

IS - 10

ER -

Delivering affordable cancer care in high-income countries

Abstract

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