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Colon Cancer Drugs Linked to Survival, Considerable Expense

In patients on the drugs, life expectancy rises 6.8 months, lifetime costs increase $37,100

FRIDAY, March 19 (HealthDay News) -- New chemotherapy drugs for metastatic colon cancer are associated with longer survival, but at steep costs that Medicare may have difficulty covering in the future, according to research published online March 16 in the Archives of Internal Medicine.

David H. Howard, Ph.D., of Emory University in Atlanta, and colleagues analyzed data from more than 12,000 patients, aged 66 and older, who were diagnosed with metastatic colorectal cancer in 1995 through 2005. Of these, 4,665 patients received chemotherapeutic medications within six months of diagnosis.

The researchers found that, in patients receiving chemotherapeutic agents, life expectancy rose by 6.8 months, with an increase in lifetime costs of $37,100. Life expectancy and lifetime costs were essentially unchanged among patients not receiving these agents. The incremental cost per quality-adjusted life-year (QALY) gained was $99,100, after discounting life-years and costs, adjusting for patients' health utility, and including their estimated out-of-pocket costs.

"New chemotherapeutic agents for colorectal cancer have been singled out as examples of high-cost/low-value medical care," the authors conclude. "Our estimate of the cost per QALY gained, $100,000, is below most estimates of the willingness to pay for a life-year. However, continuation of Medicare's open-ended coverage policy for new chemotherapeutic agents and other expensive technologies will prove difficult to sustain as costs for the program continue to rise."

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