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Integrating Value Assessment Into Discussions About the Price of Cancer Drugs

      The cost of cancer drugs is becoming untenable, both for patients and for society. More than 60% of personal bankruptcies in the United States in 2007 were attributable to health care costs, and cancer was the highest-cost diagnosis for those claiming bankruptcy for medical reasons.
      • Himmelstein D.U.
      • Thorne D.
      • Warren E.
      • Woolhandler S.
      Medical bankruptcy in the United States, 2007: results of a national study.
      One-third of insured patients with cancer use up all or most of their savings or have difficulty paying their cancer bills. Among patients with cancer who were ever uninsured, one-quarter delayed or decided to forego cancer care due to cost.
      • Henry J.
      • et al.
      Kaiser Family Foundation
      Toplines: national survey of households affected by cancer.
      Given that a cancer diagnosis can increase the cost of health insurance and interfere with employability (and, therefore, employer-sponsored insurance coverage), the risk of becoming uninsured, even temporarily, is increased. With 16% of the US population currently uninsured, the implications of these statistics are alarming.

      References

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      Linked Article

      • The High Cost of Cancer Drugs and What We Can Do About It
        Mayo Clinic ProceedingsVol. 87Issue 10
        • In Brief
          Last year, ipilimumab (Yervoy; Bristol-Myers Squibb, New York, NY) was approved by the Food and Drug Administration (FDA) for the treatment of metastatic melanoma. The benefit in survival over and above standard treatment arms was 3.7 months in previously treated patients and 2.1 months in previously untreated patients.1,2 The cost: $120,000 for 4 doses. As staggering a figure as that is, the drug is hardly alone in its lofty price. We believe that the immense cost of contemporary cancer drugs signals even greater costs for future drugs (Table).
        • Full-Text
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      • Ten Common Questions (and Their Answers) About Off-label Drug Use
        Mayo Clinic ProceedingsVol. 87Issue 10
        • In Brief
          The term off-label drug use (OLDU) is used extensively in the medical literature, continuing medical education exercises, and the media. Yet, we propose that many health care professionals have an underappreciation of its definition, prevalence, and implications. This article introduces and answers 10 questions regarding OLDU in an effort to clarify the practice's meaning, breadth of application, acceptance, and liabilities. Off-label drug use involves prescribing medications for indications, or using a dosage or dosage form, that have not been approved by the US Food and Drug Administration.
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        • PDF