References
- Keehan SP, Sisko AM, Truffer CJ et al. National health spending projections through 2020: economic recovery and reform drive faster spending growth. Health Aff. 30(8), 1594–1605 (2011).
- Mariotto AB, Yabroff KR, Shao Y, Feuer EJ, Brown ML. Projections of the cost of cancer care in the United States: 2010–2020. J. Natl Cancer Inst. 103(2), 117–128 (2011).
- IOM (Institute of Medicine). Delivering high-quality cancer care: charting a new course for a system in crisis. The National Academies Press, Washington, DC, USA.
- Tangka FK, Trogdon JG, Richardson LC, Howard D, Sabatino SA, Finkelstein EA. Cancer treatment cost in the United States: has the burden shifted over time? Cancer 116(14), 3477–3484 (2010).
- Short PF, Moran JR, Punekar R. Medical expenditures of adult cancer survivors aged <65 years in the United States. Cancer 117(12), 2791–2800 (2011).
- Bodenheimer T, Berenson R. The primary care–specialty income gap: why it matters. Ann. Intern. Med. 146(4), 301–306 (2007).
- Twombly R. Medicare cost containment strategy targets several oncology drugs. J. Natl Cancer Inst. 96(17), 1268–1270 (2004).
- Benson LR. Reimbursing cancer care: Medicare policies challenged. J. Natl Cancer Inst. 93(21), 1595–1597 (2001).
- Warren JL, Yabroff KR, Meekins A, Topor M, Lamont EB, Brown ML. Evaluation of trends in the cost of initial cancer treatment. J. Natl Cancer Inst. 100(12), 888–897 (2008).
- Schrag D. The price tag on progress – chemotherapy for colorectal cancer. N. Engl. J. Med. 351(4), 317–319 (2004).
- Meropol NJ, Schulman KA. Cost of cancer care: issues and implications. J. Clin. Oncol. 25(2), 180–186 (2007).
- Fojo T, Grady C. How much is life worth: cetuximab, non-small cell lung cancer, and the $440 billion question. J. Natl Cancer Inst. 101(15), 1044–1048 (2009).
- Smith TJ, Hillner BE. Concrete options and ideas for increasing value in oncology care: the view from one trench. Oncologist 15( Suppl. 1), 65–72 (2010).
- Hillner BE, Smith TJ. Efficacy does not necessarily translate to cost effectiveness: a case study in the challenges associated with 21st-century cancer drug pricing. J. Clin. Oncol. 27(13), 2111–2113 (2009).
- Doloresco F, Fominaya C, Schumock G. Projecting future drug expenditures – 2011. Am. J. Health Syst. Pharm. 68, e1–e12 (2011).
- Hoffman JM, Li E, Doloresco F et al. Projecting future drug expenditures – 2012. Am. J. Health Syst. Pharm. 69(5), 405–421 (2012).
- Aitken M, Kleinrock M. Declining Medicine Use and Costs: for Better or Worse? IMS Institute for Healthcare Informatics, Parsippany, NJ, USA.
- Hoffman JM, Li E, Doloresco F et al. Projecting future drug expenditures in US nonfederal hospitals and clinics – 2013. Am. J. Health Syst. Pharm. 70, 525–539 (2013).
- Chambers JD, Neumann PJ. Listening to Provenge – what a costly cancer treatment says about future Medicare policy. N. Engl. J. Med. 364(18), 1687–1689 (2011).
- Sledge GW. Musings of a cancer doctor: the cost of drugs. Oncol. Times 33(16), 32 (2011).
- Ginsburg G, Konstance R, Allsbrook J, Schulman K. Implications of pharmacogenomics for drug development and clinical practice. Arch. Intern. Med. 165(20), 2331–2336 (2005).
- Gavel S. The oncology pipeline: maturing, competitive, and growing? Oncol. Bus. Rev. 14–16 (2008).
- Conti RM, Bernstein AC, Villaflor VM, Schilsky RL, Rosenthal MB, Bach PB. Prevalence of off-label use and spending in 2010 among patent-protected chemotherapies in a population-based cohort of medical oncologists. J. Clin. Oncol. 31(9), 1134–1139 (2013).
- Siegel R, Ward E, Brawley O, Jemal A. Cancer statistics, 2011. CA Cancer J. Clin. 61, 212–236 (2009).
- Silberman G, Downs CG. Recent legislation changes the economics of cancer care. ONS News 20(7), 9 (2005).
- Iglehart J. Medicare and drug pricing. N. Engl. J. Med. 348(16), 1590–1597 (2003).
- Bailes JS, Coleman T. The new Medicare bill: far-reaching effects on cancer treatment. Clin. Adv. Hematol. Oncol. 2(5), 292–294 (2004).
- Potetz L, DeWilde LF. Cancer and Medicare: A Chartbook. American Cancer Society Cancer Action Network, Washington, DC, USA.
- Malin JL, Weeks JC, Potosky AL, Hornbrook MC, Keating NL. Medical oncologists‘ perceptions of financial incentives in cancer care. J. Clin. Oncol. 31(5), 530–535 (2013).
- Jacobson M, O‘Malley AJ, Earle CC, Pakes J, Gaccione P, Newhouse JP. Does reimbursement influence chemotherapy treatment for cancer patients? Health Aff. 25(2), 437–443 (2006).
- Shahinian VB, Kuo Y-F, Gilbert SM. Reimbursement policy and androgen-deprivation therapy for prostate cancer. N. Engl. J. Med. 363(19), 1822–1832 (2010).
- Jacobson M, Earle CC, Price M, Newhouse JP. How medicare‘s payment cuts for cancer chemotherapy drugs changed patterns of treatment. Health Aff. 29(7), 1391–1399 (2010).
- Grumbach K, Osmond D, Vranizan K. Primary care physicians‘ experience of financial incentives in managed-care systems. N. Engl. J. Med. 339(21), 1516–1521 (1998).
- McGivney WT, Mullen J. Cancer and managed care in the 21st century. Am. J. Manag. Care 11( 17 Suppl.), S509–S521 (2005).
- Timmermans S, Mauck A. The promises and pitfalls of evidence-based medicine. Health Aff. 24(1), 18–28 (2005).
- Draper D, Hurley R, Lesser C, Strunk B. The changing face of managed care. Health Aff. 21(1), 11–23 (2002).
- Garber AM. Evidence-based guidelines as a foundation for performance incentives. Health Aff. 24(1), 174–179 (2005).
- Danielson E, Demartino J, Mullen JA. Managed care & medical oncology: the focus is on value. J. Natl Compr. Canc. Netw. 8 ( Suppl. 7), S28–S37 (2010).
- Dunn JD, Ellis PG, Fox JL et al. Payer and provider collaborations that improve quality outcomes in oncology. Manag. Care. 19(11), 35–40, 42 (2010).
- Neubauer MA, Hoverman JR, Kolodziej M et al. Cost effectiveness of evidence-based treatment guidelines for the treatment of non-small-cell lung cancer in the community setting. J. Oncol. Pract. 6(1), 12–18 (2010).
- Hoverman JR, Cartwright TH, Patt DA et al. Pathways, outcomes, and costs in colon cancer: retrospective evaluations in two distinct databases. J. Oncol. Pract. 7(3S), 52s–59s (2011).
- Eichler H-G, Abadie E, Breckenridge A et al. Bridging the efficacy–effectiveness gap: a regulator‘s perspective on addressing variability of drug response. Nat. Rev. Drug Discov. 10(7), 495–506 (2011).
- Newcomer L. Cost of new oncology drugs. Clin. Adv. Hematol. Oncol. 8(5), 313–314 (2010).
- Holcombe D. Oncology management programs for payers and physicians: evaluating current models and diagnosing successful strategies for payers and physicians. J. Oncol. Pract. 7(3 Suppl.), e46s–e49s (2011).
- Blackmore CC, Mecklenburg RS, Kaplan GS. At Virginia Mason, collaboration among providers, employers, and health plans to transform care cut costs and improved quality. Health Aff. 30(9), 1680–1687 (2011).
- Regan M. Cancer and disease management: indications for action. Dis. Manag. Health Out. 6(4), 203–211 (1999).
- Ellrodt G, Cook DJ, Lee J, Cho M, Hunt D, Weingarten S. Evidence-based disease management. JAMA 278(20), 1687–1692 (1997).
- Hunter DJ, Fairfield G. Managed care: disease management. BMJ 315(7099), 50–53 (1997).
- Villagra V. Strategies to control costs and quality: a focus on outcomes research for disease management. Med. Care 42(4), 24–30 (2004).
- Kash KM, Sharma S, Goldfarb NI. Is disease management right for oncology? Popul. Health Manag. 12(6), 337–343 (2009).
- Pierce D. Managing managed care. Oncology Issues November/December, 32–35 (2005).
- Fetterolf DE, Terry R. Oncology disease management. Dis. Manag. 10(1), 30–36 (2007).
- Eijkenaar F. Key issues in the design of pay for performance programs. Eur. J. Health Econ. 14(1), 117–131 (2013).
- Chen JY, Kang N, Juarez DT, Hodges KA, Chung RS. Impact of a pay-for-performance program on low performing physicians. J. Healthc. Qual. 32(1), 13–22 (2010).
- Rosenthal M, Landon B. Pay for performance in commercial HMOs. N. Engl. J. Med. 355(18), 1895–1902 (2006).
- Hahn J, Morgan P, Stockdale H, Stone J. Medicare Provisions in PPACA (PL 111–148). Congressional Research Service.
- Rosenthal MB, Landon BE, Howitt K, Song HR, Epstein AM. Climbing up the pay-for-performance learning curve: where are the early adopters now? Health Aff. 26(6), 1674–1682 (2007).
- Siegel RD, Clauser SB, Lynn JM. National Collaborative to Improve Oncology Practice: The National Cancer Institute Community Cancer Centers Program Quality Oncology Practice Initiative Experience. J. Oncol. Pract. 5(6), 276–281 (2009).
- National Cancer Policy Board. Ensuring Quality Cancer Care. National Academy Press. Washington, DC, USA (1999).
- Desch CE, McNiff KK, Schneider EC et al. American Society of Clinical Oncology/National Comprehensive Cancer Network Quality Measures. J. Clin. Oncol. 26(21), 3631–3637 (2008).
- Newcomer LN, Perkins MR, Donelan SA. Tying payment incentives to quality measurement. J. Oncol. Pract. 9(3), 119–121 (2013).
- Chamie K, Saigal CS, Lai J et al. Quality of care in patients with bladder cancer. Cancer 118(5), 1412–1421 (2012).
- Lee TH, Bothe A, Steele GD. How Geisinger structures its physicians‘ compensation to support improvements in quality, efficiency, and volume. Health Aff. 31(9), 2068–2073 (2012).
- Mechanic RE. Opportunities and challenges for episode-based payment. N. Engl. J. Med. 365(9), 777–779 (2011).
- Stange KC, Nutting PA, Miller WL et al. Defining and measuring the patient-centered medical home. J. Gen. Intern. Med. 25(6), 601–612 (2010).
- McClellan M, McKethan AN, Lewis JL, Roski J, Fisher ES. A national strategy to put accountable care into practice. Health Aff. 29(5), 982–990 (2010).
- Mahan CE. Regulatory, policy and quality update for venous thromboembolism and stroke in United States hospitals. Thromb. Res. 130(4), 586–590 (2012).
- Sox HC. Comparative effectiveness research: a report from the Institute of Medicine. Ann. Intern. Med. 151(3), 203 (2009).
- Lyman GH. Comparative effectiveness research in oncology. Oncologist 18(6), 752–759 (2013).
- Roberts TG. Preparing for success with comparative effectiveness research. Oncologist 18(6), 655–657 (2013).
- Tunis SR, Benner J, McClellan M. Comparative effectiveness research: policy context, methods development and research infrastructure. Stat. Med. 29(19), 1963–1976 (2010).
- Miksad RA, Schnipper L, Goldstein M. Does a statistically significant survival benefit of erlotinib plus gemcitabine for advanced pancreatic cancer translate into clinical significance and value? J. Clin. Oncol. 25(28), 4506–4507, author reply 4508 (2007).
- Montero AJ, Avancha K, Glück S, Lopes G. A cost-benefit analysis of bevacizumab in combination with paclitaxel in the first-line treatment of patients with metastatic breast cancer. Breast Cancer Res. Treat. 132(2), 747–751 (2012).
- Hornberger J, Reyes C, Lubeck D, Valente N. Economic evaluation of rituximab plus cyclophosphamide, vincristine and prednisolone for advanced follicular lymphoma. Leuk. Lymphoma 49(2), 227–236 (2008).
- Garrison LP, Lubeck D, Lalla D, Paton V, Dueck A, Perez EA. Cost-effectiveness analysis of trastuzumab in the adjuvant setting for treatment of HER2-positive breast cancer. Cancer 110(3), 489–498 (2007).
- Buxton MJ. Economic evaluation and decision making in the UK. Pharmacoeconomics 4(11), 1133–1142 (2006).
- Nadler E. Do oncologists believe new cancer drugs offer good value? Oncologist 11(2), 90–95 (2006).
- Gold MR, Sofaer S, Siegelberg T. Medicare and cost-effectiveness analysis: time to ask the taxpayers. Health Aff. 26(5), 1399–1406 (2007).
- Jonsen A. Bentham in a box: technology assessment and health care allocation. L. Med Health Care 14(3–4), 172–174 (1986).
- Brock DW. Ethical and value issues in insurance coverage for cancer treatment. Oncologist 15( Suppl. 1), 36–42 (2010).
- Temel JS, Greer JA, Muzikansky A et al. Early palliative care for patients with metastatic non-small-cell lung cancer. N. Engl. J. Med. 363(8), 733–742 (2010).
- Mack JW, Weeks JC, Wright AA, Block SD, Prigerson HG. End-of-life discussions, goal attainment, and distress at the end of life: predictors and outcomes of receipt of care consistent with preferences. J. Clin. Oncol. 28(7), 1203–1208 (2010).
- Earle CC, Landrum MB, Souza JM, Neville BA, Weeks JC, Ayanian JZ. Aggressiveness of cancer care near the end of life: is it a quality-of-care issue? J. Clin. Oncol. 26(23), 3860–3866 (2008).
- Peppercorn JM, Smith TJ, Helft PR et al. American Society of Clinical Oncology statement: toward individualized care for patients with advanced cancer. J. Clin. Oncol. 29(6), 755–760 (2011).
- Levy MH, Back A, Benedetti C et al. NCCN clinical practice guidelines in oncology: palliative care. J. Natl Compr. Canc. Netw. 7(4), 436–473 (2009).
- Smith TJ, Hillner BE. Bending the cost curve in cancer care. N. Engl. J. Med. 364(21), 2060–2065 (2011).
- Neumann PJ, Palmer JA, Nadler E, Fang C, Ubel PA. Cancer therapy costs influence treatment: a national survey of oncologists. Health Aff. 29(1), 196–202 (2010).
- Meropol NJ, Schrag D, Smith TJ et al. American Society of Clinical Oncology guidance statement: the cost of cancer care. J. Clin. Oncol. 27(23), 3868–3874 (2009).
Websites
- Cancer Trends Progress Report – 2007 Update. National Cancer Institute, NIH, DHHS, Bethesda, MD, USA (2007). http://progressreport.cancer.gov ( Accessed 13 September 2013)
- Cancer Trends Progress Report – 2009/2010 Update. National Cancer Institute, NIH, DHHS, Bethesda, MD, USA (2010). http://progressreport.cancer.gov ( Accessed 13 September 2013)
- Report to the Congress: variation and innovation in Medicare. Medicare Payment Advisory Commission, Washington, DC, USA 1–230 (2003). http://medpac.gov/documents/June03_Entire_Report.pdf ( Accessed 16 September 2013)
- Berenson A. A Cancer Drug‘s Big Price Rise Is Cause for Concern. The New York Times (12 March 2006). http://nytimes.com/2006/03/12/business/12price.html?pagewanted=all ( Accessed 15 September 2013)
- Lexi-Comp Online. 2011 ed. Lexi-Drugs Online. Hudson, OH: Lexi-Comp, Inc. http://online.lexi.com/ ( Accessed 11 September 2013)
- Clinton calls for Medicare crackdown. CNNcom. (1997). http://cnn.com/ALLPOLITICS/1997/12/13/clinton.radio/ ( Accessed 28 October 2013)
- Concerns about average wholesale price-based reimbursement raised again. Cancer Network - Home of the Journal of Oncology. (2001). http: cancernetwork.com/articles/concerns-about-average-wholesale-price-based-reimbursement-raised-again ( Accessed 18 September 2013)
- Medicare Part B Drugs: Program Payments Should Reflect Market Prices. U.S. General Accounting Office, Washington, DC, USA (2001). http://gao.gov/new.items/d011142t.pdf ( Accessed 14 September 2013)
- Medicare: Payments for Covered Outpatient Drugs Exceed Providers’ Cost. U.S. General Accounting Office, Washington, DC, USA (2001). http://gao.gov/new.items/d011118.pdf ( Accessed 14 September 2013)
- Jeffrey NA, Winslow R. California jury orders Aetna to pay $116 million in damages. The Wall Street Journal (21 January 1999). http://online.wsj.com/article/SB91688814591338813.html ( Accessed 9 September 2013)
- NCCN Guidelines & Clinical Resources. 2011 ed. The National Comprehensive Cancer Network. http://nccn.org/clinical.asp ( Accessed 28 September 2013)