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Pathways to Discovery: Fall 2011

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Weighing Costs of Cancer Leads to Novel UChicago Collaboration

The burden of cancer and cost of cancer care are among the most important challenges facing the U.S.
David Meltzer, MD, PhD

Cancer carries a hefty price tag, costing an estimated $270 billion a year in the United States alone. Yet there is no ceiling in sight, as expensive new drugs, devices, and procedures hit the market with accelerating frequency. As the economic impact of cancer grows, understanding the effects of the disease will require more than clinical and biological expertise.

To achieve a richer understanding of the costs of cancer, The University of Chicago has established an Initiative in the Economics of Cancer. Led by economist Ya-Chen Tina Shih, PhD, the first-of-its-kind program will look at cancer and its treatment in the real world, where patients have varying priorities and healthcare dollars are finite. By uniting cancer researchers with experts from the social sciences, Dr. Shih’s group aims to weigh the costs and benefits of these new technologies so that patients receive the best, most logical care, rather than just the latest, often-pricey option on the market.

“What we would like to do is provide an environment that enables oncologists to study those questions without having to learn everything themselves,” Dr. Shih said. “They   can team up with economists or people in operations research or health services research, and can work on issues together. Similarly, people with no medical training who are interested in exploring those questions can find their clinical collaborators here.”

Analyzing Cancer’s Costs
To calculate the cost of cancer, one must go beyond money spent on drugs, procedures, doctor’s appointments, and devices. Other contributors are the indirect cost of missing work due to illness, side effects or surgery, permanent loss due to death, and a patient’s quality of life under different treatments.

Performing a cost-effective analysis can help determine if a new treatment is a significant enough improvement over the current standard of care to justify coverage by insurance companies; however, current clinical trials often do not incorporate the measures needed to conduct such an analysis.

Dr. Shih hopes that the Initiative in the Economics of Cancer, funded in part by a grant from The University of Chicago Cancer Research Foundation Women’s Board, will help cancer researchers design clinical trials with economic questions in mind. Such trials would allow researchers to gather information about costs before the potential release of new technologies that may provide very small benefits relative to substantial costs.

“You don’t at the conclusion of a trial say ‘let’s add a cost-effectiveness analysis to that.’ By then, it’s way too late,” Dr. Shih said. “The idea is to get more people interested in collecting these data at early time points, so that when they really want to answer a question, they have the data to answer it.”

Looking at new treatments through an economic lens can help predict the impact of the technology after the clinical trial.

“We serve underserved populations, so our physicians have an interest in knowing the impact of newer technologies and if there are access issues where cost may be a barrier to receiving good care,” Shih said. “Those are the types of information produced from our research that might be helpful to them.”

“The burden of cancer and cost of cancer care are among the most important challenges facing the U.S.,” said David Meltzer, MD, PhD, associate professor of medicine and chief of the Section of Hospital Medicine. “The University of Chicago’s strength in economics and cancer and its rich tradition of interdisciplinary research make it an ideal place for the development of this program.”

Tina Shih cancer economis