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Multiagent Colorectal Cancer Regimens of Low Value in Terms of Cost, Survival


February 25, 2016

While the rate of patients 75 years and older with metastatic colorectal cancer receiving 3 or more treatments increased from 2% to 53% over a 10-year period, the median survival for this population increase by only one month, leading some researchers to believe that “taken together, multiagent regimens may not be of high value in terms of costs and survival.” During the study period, the 1-year cost of treatment increased 32%, reaching an estimated $2.2 billion annually.

A study published online ahead of print in the journal Medical Care looked at data from over 20,000 Medicare patients with metastatic colon or rectal cancer from 2000 to 2009. Researchers examined the percentage of these patients treated with chemotherapy or a target agent (bevacizumab), which has shown survival benefits in younger patients as well as those in an earlier stage of the disease. The study showed a benefit was not evident in patients older than 75 years of age who had metastatic cancer.

According to the study, a large portion of the extra cost of treatment is paid for by the patient. In 2000, patients in the study paid about $11,000 in out-of-pocket expenses; by 2009 that number jumped to $16,000. Patients who were not treated with chemotherapy had significantly lower costs—less than $5000 in the year following diagnosis.

Additional costs are also associated with these agents, such as helping patients cope with side effects and incurred additional hospital inpatient charges.

 

 

Reference: Bradley CJ, Yabroff KR, Warren JL, Zeruto C, Chawla N, Lamont EB. Trends in the treatment of metastatic colon and rectal cancer in elderly patients. Med Care. 2016, February [Epub ahead of print].

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