Unbiased Analysis of Today's Healthcare Issues

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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Benefits of mammogram oversold?

That is what one new study finds. The Boston Globe reports that: Doctors may have oversold the benefits of mammography and underplayed its risks, which has left many women unable to make an informed decision about whether or not to have regular breast cancer screenings beginning at age 40. That troubling finding is based on […]

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Cancer Tidal Wave

People are living longer. That is good news. The bad news is that when you decrease the mortality rates for some diseases, you increase the likelihood that you die from other ones. For instance, if someone previously would have died of a heart attack at 50 year old in 1950, if that same person turned […]

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Trends in Cancer Care Near the End of Life

The Dartmouth Atlas released a new report describing how end-of-life cancer care is changing over time. Their analysis uses data from a 20 percent sample of all Medicare beneficiaries who died between the ages of 66 and 99 years during 2010, who had cancer diagnosis with a poor prognosis. The authors find that: Deaths in […]

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Thoughts on IOM’s ‘Delivering High-Quality Cancer Care’ Report

The Institute of Medicine (IOM) makes a number of recommendations on how to improve cancer care in their 2013 report.  I have listed them all here.  For some of these recommendations, I have comments below. The Centers for Medicare & Medicaid Services and other payers should design, implement, and evaluate innovative payment models that incentivize […]

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Access to Oncology Care

Oftentimes, health services research measure access as the distance between a patient and the nearest provider of a given type (e.g., hospital, physician).  This issue of access is particularly relevant for individuals with cancer, since cancer care typically requires supervisions from specialist oncologists.  In most cases, health services researchers assume that individuals located far from […]

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Cost of Cancer in Europe

In 2008, 2.45 million people were diagnosed with cancer and 1.23 million died because of cancer in the European Union (EU). What is the economic burden of cancer?  A paper by Luengo-Fernandez (2013) aims to estimate just this quantity.  They find that: Cancer cost the EU €126 billion in 2009…Across the EU, the health-care costs […]

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