Drug companies provide so much of the funding for major patient groups that many critics say they've stifled a key voice in the policy debate over soaring drug prices, especially over those for cancer.--Jayne O'Donnell , USA TODAY
Terms like "value" and "cost" are vague and mean nothing without context. If you follow the ongoing drug pricing narrative you have heard the argument--prices are high because of downstream benefits of one therapy over another. Gilead's hepatitis drug may eliminate the need for transplantation--an obvious cost savings although how are health systems able to afford the point of sale costs.
An important resource for adverse event data--FDA Adverse Event Reporting System is publically available although there can be a high degree of complexity. Head over to data talks, people mumble for data focused blogs of interest. If you prefer step by step guidance I will include a few case studies in Blueprint: a scalable healthcare data strategy available for pre-order ($2.99) for e-book but here I will keep it a little more high level to keep more eyeballs following along.
I recently reviewed an embargoed study examining the varying costs of breast cancer treatments. Understanding how the calculations are estimated is helpful when evaluating quality of the evidence and insights provided.
CANCER News Alert
Embargo/Online Publication Date: 00:01 AM ET, Monday, October 10, 2016
[05.01 Hours UK Time (BST)/14:01 Hours Australian Eastern Standard Time (AEST), October 10]
NOTE: The information contained in this release is protected by copyright. Please include journal attribution in all coverage.
Costs of Similarly Effective Breast Cancer Treatments Vary Widely
A new study finds that the costs of breast cancer chemotherapy vary widely, even among treatment regimens with similar efficacy, and that patients bear a substantial out-of-pocket burden. Published early online in CANCER, a peer-reviewed journal of the American Cancer Society, the study is the first to examine these cost differences, providing clinicians with accessible information to answer patient questions about their treatment options.
To estimate the costs to payers and patients for breast cancer treatment regimens, Sharon Giordano, MD, MPH, of The University of Texas MD Anderson Cancer Center in Houston, and her colleagues assessed information on 14,643 women who were diagnosed with breast cancer between 2008 and 2012 and who received chemotherapy within three months of diagnosis. Total and out-of-pocket costs were calculated using all claims within 18 months of diagnosis and were normalized to 2013 dollars.
Among the major findings:
Although representing a linear discussion of costs associated with the duration of care it is difficult to know for certain what downstream additional costs may result from different regimens.
There are a wide-variety of care costs likely to occur outside of the short window being evaluated such as breast reconstruction or ongoing care regimens.
An advantage of alternative data sources such as registries provide inclusion of cancer stage, ethnicity, or tumor characteristics.
A careful review of the literature may help identify adverse event data coded in the Medical Dictionary for Regulatory Activities [MedDRA]). Not a freely available resource but certainly affordable. It is coded in many clinical trials and eliminates the need to cross-reference data to correct spelling errors and erroneous abbreviations. I work with a historic phase III cancer registry that codes in lowest level MedDRA allowing adverse event data to be grouped into related events.
If you find it helpful to be introduced to a variety of resources available to help ongoing discussions of real world evidence I encourage you to follow along. Many topics are replies to specific questions I receive throughout the week so feel free to engage over on twitter or linkedin.
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Bonny is a data enthusiast applying curated analysis and visualization to persistent tensions between health policy, economics, and clinical research in oncology.