People diagnosed with advanced colon cancer pay twice more per month for treatment in the US than in Canada but do not live any longer, according to research presented at the American Society of Clinical Oncology (ASCO) conference in Chicago, IL. The paper, ‘Systemic Therapy Costs and Use in Patients With mCC’ (Abstract LBA3579), reported that the use and cost of systemic therapy for metastatic colorectal cancer is significantly higher for patients in western Washington state in the US compared to those in British Columbia, Canada, with no significant differences in overall survival.
Researchers from the Fred Hutchison Cancer Research Center in Seattle, WA, analysed data from 1,622 patients in British Columbia and 575 in Washington. They found that patients in British Columbia were more likely to be older (median age, 60 vs. 66) and male (57% vs. 48%, p=0.01) than those in Washington. The most common first-line regimen in British Columbia was FOLFIRI plus bevacizumab (32%), whereas FOLFOX was the most common first-line regimen in Washington (39%).
"To our knowledge, this is the first study to directly compare treatment cost and use, along with health outcomes, in two similar populations treated in different health care models," said lead author, Dr Todd Yezefski, a senior fellow at the Fred Hutchison Cancer Research Center in Seattle, Washington. The findings "may help us improve care and potentially lower health care costs," he added.
The mean monthly cost of first-line therapy per patient was US$12,345 in the US vs. US$6,195 in Canada (p=0.01) for all regimens assessed. Mean lifetime monthly costs were also significantly higher in Washington (US$7,883 vs. US$4,830, p=0.01). Overall median survival of patients receiving therapy was similar (21.4 months in Washington vs. 22.1 months in British Columbia), with similar overall median survival among those who did not receive therapy (5.4 months in Washington vs. 6.3 months in British Columbia).
"As oncologists, we see the burden of high costs on patients and their families every day," said ASCO chief medical officer, Richard Schilsky. "This study adds important context to the ongoing national conversation about rising treatment costs."