Unbiased Analysis of Today's Healthcare Issues

The value of surrogate endpoints for predicting real-world survival across five cancer types

You can find one of my recent papers measuring how well survival measures from clinical trials (i.e., overall survival, progression free survival, time to progression) translate into real-world survival outcomes in Current Medical Research and Opinion here.  The abstract is below.   Objective It is unclear how well different outcome measures in randomized controlled trials (RCTs) perform in […]

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How to cure cancer

Clinical progress against a disease as wily and dimly understood as cancer, DeVita argues, happens when doctors have the freedom to try unorthodox things—and he worries that we have lost sight of that fact. Excerpt from “Tough Medicine: A disturbing report from the front lines of the war on cancer” by Malcolm Gladwell in the New Yorker.

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Medicare in the data analysis business?

From a recent N.Y. Times article on Vice President Joe Biden’s cancer “moonshoot”: The researchers pointed out that although genome sequencing seems to be rapidly transforming cancer research, a tiny fraction of cancer patients are having their tumors sequenced because most insurers, including Medicare, will not pay for the procedure. For a start, the group told […]

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Cancer rates in the developing world

NPR reports that the developing world that cancer rates are increasing in the developing world.  In fact: The majority of cancer cases — 57 percent — now occur in low- and middle-income countries. And 65 percent of cancer deaths worldwide occur in these countries, according to an analysis by the American Cancer Society. But there’s […]

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NCCN Evidence Blocks

NCCN recently released a new approach to measure the value of cancer medicines. The approach–known as Evidence Blocks–evaluates medications on 5 dimensions: Efficacy of regimens, Safety of regimens, Quality and quantity of evidence for regimens, Consistency of evidence for regimens, and Affordability of regimens. Each criteria is ranked on a 1 to 5 block scale. […]

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What is the cancer incidence rate in your state?

Find out at the CDC’s website. They have incidence information by cancer type and gender for all states between 1999 and 2012. Below is a sample chart you can produce with these data.

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What is they key driver of cancer care spending?

High-cost cancer drugs often get bad press. Cancer treatment certainly is expensive. However, drug costs are not the primary driver of high cost of cancer treatment; hospitalizations are. Using data from SEER-Medicare, Brooks et al. (2014) examine regional variation in the cost of cancer care and find: Acute hospital care was the largest component of […]

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A Neurosurgeon and A Patient

The moving story of Paul Kalanithi. That message is simple: When you come to one of the many moments in life when you must give an account of yourself, provide a ledger of what you have been, and done, and meant to the world, do not, I pray, discount that you filled a dying man’s […]

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Cancer Care Myths

Below are excerpts from a recent Health Affairs paper by Goldman and Philipson (2014): Myth #1: The War on Cancer has been a failure.  Survival rates for all cancers increased by almost four years during the period 1988–2000. Myth 2: Detection, Not Treatment, Accounts For Most Of The Survival Gains.  During 1988–2000 almost 80 percent of […]

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How did Medicare pay for chemotherapy pre-2006?

A working paper by Jacobson et al. (2014) not only provides the answer, but describes how reimbursement policy change over the past decade. Although Medicare did not offer a drug benefit for oral drugs (pills) until 2006, Medicare Part B, which covers physician services, has from inception covered physician-administered drugs such as IV chemotherapy, anti-nausea, […]

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