High cost of cancer care in US does not improve survival rate, study finds

The United States spends twice as much as the average for developed countries on cancer care, but gets only average results in return, according to a study released Friday. These results were published in the Journal of the American Health Association Health Forum. “The United States is widely seen as offering the most advanced cancer care in the world“, by developing and authorizing new treatments faster than elsewhere, explained the main author Ryan Chow, doctoral student at Yale University, in a press release. That’s why his team tried to find out if this translates to better results.

Among 22 high-income countries, the researchers found that the United States had by far the highest rate of spending: $200 billion a year for cancer care, or about $600 per capita, twice the average of $300 per capita for these developed countries. And the scientists found that this extra expense did not lead to better survival rates nationwide. “In other words, countries that spend more on cancer care do not necessarily have better outcomes.“summarized Ryan Chow. The United States scores slightly above average, while six countries – Australia, Finland, Iceland, Japan, South Korea and Switzerland – fare even better with lower expenses. Of the countries analyzed, South Korea and Japan have the lowest death rates while Denmark has the highest, followed by France.

Smoking is the biggest driver of cancer-related mortality, raising hopes of better cancer outcomes in countries where the number of smokers is traditionally low, such as the United States. After adjusting the results for the number of smokers, the researchers concluded that nine countries – Australia, Finland, Iceland, Japan, South Korea, Luxembourg, Norway, Spain and Switzerland – had better cancer survival rates than the United States, which puts it in the middle of the pack.

Drugs more expensive in the United States than elsewhere

The explosion in the cost of care in the United States has many factors, explains the study. Expenditure on drugs represents 37% of the costs paid by private insurance for cancers, and these treatments cost much more in this country than elsewhere. Unlike other countries with public health care systems, the state-provided health insurance in the United States, Medicaid, does not have the power to negotiate pharmaceutical prices. And the US medicines agency, the FDA, does not take drug pricing into account when deciding whether to authorize them, unlike other countries like Britain where cost-effectiveness must be taken into consideration. .

Researchers also attribute much of the rising drug costs to new types of treatments, such as monoclonal antibodies, kinase inhibitors and some immunotherapy methods, although their effectiveness is often marginal. Finally, American medical services often push treatments further: “In the last six months of life, American cancer patients are twice as likely to be admitted to intensive care as in other countries and are more likely to receive chemotherapy.» «The United States has a lot to learn from other countries and systems, if it were willing to changesaid co-author Elizabeth Bradley, president of Vassar University.

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