A Snapshot of Cancer Spending and Outcomes

Gonzales, S.; Cox, Cynthia; Jankiewicz, Anne; Rousseau, David

doi:10.1001/jama.2016.7250

Cited by 4 publications

(3 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Therefore, our findings may be a reflection of the profound impact that health policies and delivery at a state level have on clinical outcomes. Early detection and appropriate treatments for lung cancer, including surgical interventions and advanced therapies, lead to large health expenditures (30)(31)(32). For example, Vera-Llonch et al in their study, indicated that health care costs among patients with metastatic lung cancer receiving chemotherapy are substantial, exceeding $125,000 per patient over a mean follow-up period of 500 days.…”

Section: Discussionmentioning

confidence: 99%

State-Level Disparity in Lung Cancer Survival in the United States

et al. 2020

View full text Add to dashboard Cite

The cancer mortality-to-incidence ratio (MIR) can serve as a population-based indicator for cancer care outcomes. In the US, evaluation of lung cancer survival by individual states has not been evaluated. Objective: To assess the association between lung cancer survival by using MIRs and state-level health disparities in the United States. Methods: We calculated 5-year lung cancer MIR averages from 2011 to 2015 using the United States Cancer Statistics (USCS) data. America's Health Rankings (AHR) is a platform using weighted measures in five different categories to calculate annual state health rankings. Five-year averages from 2011 to 2015 of the health uninsured rate and 4-year averages from 2011 to 2014 of health spending per capita were obtained from the U.S. Census Bureau and Centers for Medicare & Medicaid Services. Linear regression analyses were performed to determine the associations between cancer survival value (CSV) = (1-MIR) × 100% and state health variables. Results: During the study period, the 5-year averages of age-adjusted incidence, mortality rates, and CSVs were 60.3 ± 2.1 per 100,000 population, 43.4 ± 2.1 per 100,000, and 27.9 ± 3.9%, respectively. Among the 50 states, Connecticut had the highest CSV (38.6 ± 1.7%) whereas Nevada had the lowest CSV (18.7 ± 6.5%). Hawaii had the highest health ranking and Mississippi had the lowest ranking in 2016. States with better health rankings, lower health uninsured rates, and higher health spending were significantly associated with higher CSVs (R 2 = 0.418, P < 0.001; R 2 = 0.352, P < 0.001; R 2 = 0.142, P = 0.007, respectively). Conclusions: There are significant differences in lung cancer survival within the United States. Lung cancer survival by using CSV was strongly associated with state health disparities, and it can be an applicable measure to evaluate the state-level health disparities in the United States.

show abstract

Section: Discussionmentioning

confidence: 99%

State-Level Disparity in Lung Cancer Survival in the United States

et al. 2020

View full text Add to dashboard Cite

show abstract

“…2 The Kaiser Family Foundation estimates that cancer care is the seventh most expensive condition to treat in America, accounting for 7% of all 2020 US healthcare spending. 3 As cancer becomes more prevalent, focus on research and treatment is intensifying, with the National Cancer Institute (NCI) investing $1.8 billion over 7 years to the Cancer Moonshot program, aimed at accelerating progress in cancer research. 4 Much of this money goes to NCI-designated Comprehensive Cancer Centers (NCICCC), which are academic hospitals designated by the NCI as having exceptional depth and breadth of basic, clinical, translational, and transdisciplinary research, as well as renowned leadership and resources dedicated to clinical cancer care.…”

Section: Introductionmentioning

confidence: 99%

“…In New York State (NYS) alone, hospital care for all conditions accounted for nearly $110 billion, or about 8% of NYS's 2020 real gross domestic product 2 . The Kaiser Family Foundation estimates that cancer care is the seventh most expensive condition to treat in America, accounting for 7% of all 2020 US healthcare spending 3 …”

Section: Introductionmentioning

confidence: 99%

Comparing hospital costs and length of stay for cancer patients in New York State Comprehensive Cancer Centers versus nondesignated academic centers and community hospitals

Fodero,

Bailey

2023

Health Services Research

View full text Add to dashboard Cite

ObjectiveTo explore differences in costs and lengths of stay for cancer patients admitted to National Cancer Institute‐designated Comprehensive Cancer Centers, nondesignated academic medical centers, and community hospitals in New York State.Data SourcesWe use patient‐level data from the New York State Statewide Planning and Research Cooperative System Hospital Inpatient Discharges dataset for the years 2017–2019.Study DesignWe employ ordinary least squares and Poisson regressions to compare hospital costs and length of stay for cancer patients, controlling for hospital type, patient demographics, and patient health. Our key outcomes are differences in costs and lengths of stay.Data CollectionWe use data on patient demographics, total treatment costs, and lengths of stay for patients discharged from New York hospitals with cancer‐related diagnoses between 2017 and 2019.Principal FindingsWe determine that inpatient costs were 27% higher (95% CI 0.252, 0.285), but length of stay was 12% shorter (95% CI −0.131, −0.100), in Comprehensive Cancer Centers relative to community hospitals.ConclusionsThe results imply that, in New York State, Comprehensive Cancer Centers are a magnet for more complex oncology cases and administer more expensive treatments. That expertise, however, seems to be responsible for more efficient care delivery and thorough discharge planning, allowing for shorter average lengths of stay.

show abstract

Checkpoint Inhibitors in Lung Cancer Are Not Immune from Cost-Effectiveness Analysis

Kelly

Smith

2016

Journal of Thoracic Oncology

View full text Add to dashboard Cite

Systemic therapy including platinum-based chemotherapy and targeted therapy has been a mainstay of treatment for the majority of patients with metastatic non-small-cell lung cancer (NSCLC). Recent breakthroughs in immune checkpoint blockade, along with a deeper understanding of tumor immune biology, have led to a paradigm shift in the standard of care for cancer treatment. By activating the immune system to recognize and eliminate cancer, immune checkpoint blockade has the potential to elicit durable responses and augment survival outcomes for a subset of patients [1,2]. In addition, the ability of radiotherapy to induce an immunogenic response and neutralize the immune-suppressive effects of the tumor microenvironment, uniquely positions it as a synergistic tool at the center of emerging multimodal therapies utilizing immune checkpoint blockade [3-7]. Immune checkpoint inhibitors of the PD-1/PD-L1 pathway have emerged as a promising new therapeutic strategy [8-11]. These agents have produced durable clinical responses and antitumor activity in Phase I trials, leading to subsequent randomized Phase II and III trials that demonstrated significant improvements in overall survival when compared with cytotoxic chemotherapy alone [12-16]. These studies have established PD-1/PD-L1 pathway blockade as a powerful new line of therapy for patients with advanced NSCLC following progression after platinum-based therapy [9,11]. Despite unprecedented improvements in clinical outcomes, less than 20% of patients respond to anti-PD-1/PD-L1 agents, necessitating strategies that explore combined treatment modalities in order to extend the benefits of immune checkpoint blockade to a broader patient population. The Phase II KEYNOTE-021 trial (NCT02039674), for example, evaluated the treatment of pembrolizumab in combination with pemetrexed and carboplatin and found significantly prolonged progression-free survival (median 13.0 vs 8.9 months; 6-month survival 92% for both arms) for patients with previously untreated metastatic nonsquamous NSCLC [17]. This trial, as well as the KEYNOTE-024 trial (NCT02142738), has served to bring PD-1 inhibition into the front-line setting for NSCLC [13]. Radiation has become known for its abscopal effect in lung cancer. There are many compelling reasons to combine radiotherapy with checkpoint inhibition in the treatment of NSCLC. Radiation affects the immune system in many ways including release of neoantigens, upregulation of PD-L1 on tumor cells, recruitment of T cells to the tumor bed and neutralization of the immune-suppressive effects of the tumor microenvironment. Over 60% of patients with NSCLC require radiotherapy at least once during their course of treatment, and radiotherapy used in combination with immune checkpoint blockade has shown potential in preclinical and early clinical studies [3,6,7,18]. A Phase II trial of consolidation pembrolizumab initiated 1-2 months after concurrent chemoradiation demonstrated safety of such treatment [19]. In fact, in May 2017, AstraZeneca and MedImmune a...

show abstract

A Snapshot of Cancer Spending and Outcomes

Cited by 4 publications

References 0 publications

State-Level Disparity in Lung Cancer Survival in the United States

State-Level Disparity in Lung Cancer Survival in the United States

Comparing hospital costs and length of stay for cancer patients in New York State Comprehensive Cancer Centers versus nondesignated academic centers and community hospitals

Checkpoint Inhibitors in Lung Cancer Are Not Immune from Cost-Effectiveness Analysis

Contact Info

Product

Resources

About