Incidental Economist blasts Health Affairs cancer care costs paper but praises journalist

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Aaron Carroll, blogging on The Incidental Economist was “all riled up to get angry” over a Health Affairs paper that suggestedthat the higher-cost US system of cancer care delivery may be worth it.”  He wrote:

So much wrong here. First of all, it uses the old “survival rate”/”mortality rate” swap that I’ve discussed here and here and here and here and here. If you want to show that things are better, study the mortality rate, not the survival rate.

More importantly, there is nothing in this study – nothing – that proves that spending more is what improves things, even if things are better. There’s no causality at all.

So I braced for the worst in the media. But then Sharon Begley became my new hero:

Cancer patients in the United States who were diagnosed from 1995 to 1999 lived an average 11.1 years after that, compared with 9.3 years for those in 10 countries in Europe, researchers led by health economist Tomas Philipson of the University of Chicago reported in an analysis published Monday in the journal Health Affairs.

Those extra years came at a price. By 1999 (the last year the researchers analyzed), the United States was spending an average of $70,000 per cancer case (up 49 percent since 1983), compared with $44,000 in Europe (up 16 percent). Using standard figures for an extra year of life, the researchers concluded that the value of the U.S. survival gains outweighed the cost by an average $61,000 per case. The greater spending on cancer care in the United States, they conclude, is therefore “worth it.”

Experts shown an advance copy of the paper by Reuters argued that the tricky statistics of cancer outcomes tripped up the authors.

“This study is pure folly,” said biostatistician Dr. Don Berry of MD Anderson Cancer Center in Houston. “It’s completely misguided and it’s dangerous. Not only are the authors’ analyses flawed but their conclusions are also wrong.”

Wait…  is that actual reporting, and not a rehashing of a press release? More, please! …

Please go read the whole thing. And then start a campaign to get Sharon Begley a raise and a promotion.



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Comments (2)

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Naomi Freundlich

April 17, 2012 at 11:52 am

Kudos to Sharon Begley for digging deeper into this story. I found similar serious problems in the Health Affairs piece, including the lead time problem as well as not mentioning the cost of treatments that cause only pain and suffering at the end of a cancer patient’s life. Here’s a link to my post on Reforming Health blog: