When prescribing medicines, oncologists often don’t consider the cost. In other words, they don’t require any more benefit, or months of survival, from an expensive drug when compared with a less expensive one, according to a new research study appearing in the April issue of Health Affairs.
Peter Ubel, lead author and a physician and behavioral scientist who teaches marketing at Duke University’s Fuqua School of Business, said, “For patients battling cancer or consumers faced with the very real prospect that they may one day contract the disease, it may be reassuring to know that oncologists aren’t basing their recommended treatments on the price of the medicines.”
“But insensitivity to prices may contribute to the ever-escalating costs of new cancer medicines,” Ubel added. “If oncologists’ expectations of a treatment don’t rise in accordance with the price of the treatment, the pricing of these drugs will be skewed. This can lead to very expensive, ineffective medicines.”
Ubel and a team of co-authors from the US and Canada surveyed 1389 members of the American Society of Clinical Oncology in the US along with English-speaking oncologists in Canada. The researchers presented situations intended to assess the degree of benefit oncologists believe novel treatments should provide in order to warrant the costs of these treatments.
Specifically, the survey presented a hypothetical new chemotherapy drug and asked oncologists how much benefit, or life expectancy gain, the drug would need to offer to merit its use.
“When presented with general hypothetical questions about the costeffectiveness of medicines, more than two-thirds of respondents said treatments costing greater than $100,000 per year of life were not good value for money,” Ubel said. “But this attitude contradicts their answers to our survey questions about a specific clinical scenario, when oncologists endorsed spending several hundred thousand dollars per life-year gained. In other words, they are sensitive to price in the abstract, but they abandon their notions of a price threshold when considering treatment for an individual patient.”
The researchers suggest efforts be made to improve physicians’ attention to the economic consequences of their clinical decisions and, furthermore, develop ways to ensure medical treatments bring proper value for their costs.