Health Outcomes and Pharmacy Practice Division, The University of Texas at Austin, College of Pharmacy, 1 University Station A1900, Austin, TX 78712, USA.
Expert Rev Pharmacoecon Outcomes Res. 2014 Feb;14(1):35-44. doi: 10.1586/14737167.2014.864561. Epub 2013 Dec 13.
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.
美国国内生产总值的约 18%用于医疗保健，其中 5%用于癌症护理。随着肿瘤药物价格的迅速上涨，癌症支出的增长速度可能远远超过整体医疗保健支出的增长速度。制定节约成本的策略是当务之急，但节约成本绝不能以牺牲患者的福祉为代价。以最经济的价格提供高质量的护理是主要目标。本文总结了癌症成本上升的趋势，并回顾了成本管理策略，包括《平价医疗法案》中提出的策略。许多项目通过纠正效率低下、防止治疗失败和消除错误来节约成本。流程改进很重要，但在肿瘤学中，药物大大推高了成本。确定最有效和最经济的治疗方法需要进行成本效益研究。按照目前的速度，美国的支付方无法继续为癌症治疗的不断增加的成本买单。为合理成本实现患者最大获益的研究至关重要。更多关于生活质量评估和成本效益的分析可以为未来的癌症护理决策提供支持。
