The Costlier the Better

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The Costlier the Better

More expensive breast cancer treatments linked to better survival

Higher treatment costs for illnesses like breast cancer are linked to a greater chance of survival, according to new research from the Yale School of Medicine.

The study, which appears in the April issue of Health Affairs, analyzed Medicare billing records of 9,708 women across the country between the ages of 67 and 94, who were diagnosed with stage 2 or stage 3 breast cancer. The research team assessed trends in treatment costs and survival rates between 1994 and 1996 and compared them to trends from 2004 and 2006.

Over the course of a decade, Medicare costs for women with stage 3 breast cancer increased from $18,100 to about $32,600, while the five-year survival rate improved from 38.5 percent to nearly 52 percent. The costs of caring for women with stage 2 breast cancer also rose dramatically—by more than 40 percent (from $12,300 to $17,400)—but the improvement in five-year survival was more modest (68 percent to 72.5 percent).

“Our findings indicate that in some instances, newer and costlier approaches may be leading to improved outcomes in breast cancer patients,” said lead author Cary P. Gross, M.D., professor of internal medicine at Yale. “Now we need to tackle the harder questions about what we can afford to pay, and find out which treatments are effective for each patient.”

The bigger price tag was largely attributed to substantial increases in the cost of chemotherapy and radiation therapy, Dr. Goss said. “The pattern is clear: Higher costs of breast cancer care have been accompanied by improvements in survival.”

Study first author Aaron Feinstein, M.D., a resident in head and neck surgery at UCLA, agreed, calling their findings a “glass half-full” situation. “Survival is improving, although costs are rising substantially. We need research that can help us not only to develop new treatments, but to learn how to contain costs while we are advancing patient care.”

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BHM Edit Staff