While certain newer approaches to prostate cancer treatment, such as less invasive surgery and advanced radiation therapy, may be “doctor recommended and patient preferred,” are they worth the additional price tag? That’s what Dr. Paul Nguyen of the Dana-Farber Cancer Institute and Brigham and Women’s Hospital set out to discover in his study comparing the type and cost of prostate cancer treatments administered between 2002 and 2005.
Published in the Journal of Clinical Oncology, Dr. Nguyen and his colleagues analyzed data from 45,000 men on Medicare and found that among those who had prostate cancer surgery in 2002, about one out of 100 received minimally invasive surgery, a procedure costing a few hundred dollars more than conventional surgery. That number increased to 28 out of every 100 men in 2005. Researchers also found that in 2002, 28 out of 100 men received intensity modulated radiation therapy, which runs about an extra $11,000 more than 3D conformal radiation therapy. In 2005, the number of men treated with advanced radiation therapy jumped to 81 out of 100.
Despite the increase in popularity for newer technologies in the treatment of prostate cancer, Dr. Nguyen notes, “There really isn’t data on whether this saves more lives,” thus rendering the question, is it worth the cost?
ACSH's Dr. Elizabeth Whelan wonders, “What is the FDA’s role in approving various new therapies? For instance, does the agency have to review safety and efficacy data for 3D conformal radiation therapy before approving the new technology as a treatment for prostate cancer? Does the relative cost enter into such decisions? Or do the state medical boards play a role, since the question in essence is one of medical practice?”
Dr. Whelan’s query piqued ACSH's Dr. Gilbert Ross’s curiosity as he himself wonders, “What role does the FDA play in either discouraging, encouraging or approving such discretionary approaches to the diagnosis and treatment of various diseases? If this decision is solely in the province of physician and patient discussion, then the cost-benefit — not to mention the marginal benefit concerns — would likely take a back burner as everyone would seek the ‘latest’ technology.”