The United States spends more on cancer care than European countries. Some people have argued that this extra expense is unwarranted, because US patients with cancer have similar or worse outcomes despite this increased spending. However, data from a new study suggest that the higher spending for cancer in the United States than in 10 European countries may be worth the additional expense (Philipson T, et al. Health Aff [Millwood]. 2012;31:667-675).
The survival differences in this study for patients who were diagnosed with cancer between 1995 and 1999 show that, on average, in the United States patients lived 11.1 years after a cancer diagnosis compared with only 9.3 years in Europe, an average increase of 1.8 years in survival. By comparing these survival differences to the relative costs of cancer care, the researchers found that although US patients paid more for cancer care, they had better survival outcomes.
Even after considering higher US costs for treatment, the extra survival time was worth an aggregate of $598 billion—an average of $61,000 per patient. For most solid-tumor cancers, in particular for breast and prostate cancers, even after considering the higher costs, US patients had greater survival gains than European patients. The value of additional survival gains was highest for patients with prostate cancer ($627 billion) or breast cancer ($173 billion).
In addition, each $100 increase in per-capita spending on cancer—approximately $20,000 per patient with cancer—was associated with an average of another 2.3 years of life. The researchers concluded that the higher-cost cancer care in the US healthcare system may be “worth it,” because it delivers improved outcomes and longer survival for patients.
They cautioned, however, that their findings do not prove a causal link between spending on cancer care and survival gains. The US survival gains may be a result of a more rapid uptake of new technologies, earlier access to new cancer drugs, or increased cancer screening. Furthermore, because they used databases from 1983 to 1999, these results may be outdated and skewed. Recent important changes in cancer care—including the introduction of costly new drugs and the increased use of diagnostic imaging—may lead to different results using more up-to-date data.
