Trends and issues in oncology costs.

Approximately 18% of US gross domestic product is spent on healthcare and 5% of that is for cancer care. With rapidly increasing oncologic drug prices, growth in cancer spending will likely far outpace overall healthcare spending growth. Developing cost-saving strategies is imperative, but economizing must not compromise patients' well-being. Providing quality care at the most economical price is the main aim. This article summarizes trends in rising cancer costs, and reviews cost-management strategies, including those proposed in the Affordable Care Act. Many programs economize by correcting inefficiencies, preventing therapeutic failures and eliminating errors. Process improvement is important, but in oncology, medications substantially drive costs. Identifying the most effective and economical treatments requires cost-effectiveness research. At the current pace, the US payers cannot continue to afford increasing costs for cancer treatments. Research on maximizing patient outcomes for reasonable costs is essential. More analyses of quality of life assessment and cost-effectiveness can support future decisions about cancer care.