Oncologists and medical doctors work closely with cancer patients to design a plan of treatment that will give them the highest chance of survival. Individuals who are diagnosed with particularly aggressive cancers that are terminal are often presented with multiple treatment options. Doctors work with patients and family members to decide which treatment will be most beneficial physically, emotionally, and even financially. Unfortunately, insurance coverage often dictates which treatment plan will be chosen, regardless of whether it extends life expectancy the most or not. Patients and doctors have become frustrated with the limited choices afforded to them by insurance companies in recent years. Public outcry has created the need for additional research that measures a patient’s value on medical treatment options.
In response to this need, Darius N. Lakdawalla, director of research at the Leonard D. Schaeffer Center for Health Policy and Economics at the University of Southern California in Los Angeles recently conducted a study that examined how much risk individuals would be willing to take with their treatment if they had the chance of living longer. Lakdawalla asked individuals diagnosed with either advanced breast cancer or melanoma whether they would prefer to have a guarantee of surviving for a specific period of time or would they rather take their chances with a treatment plan that gave no guarantee at all, but offered the hope of longer survival. He also assessed how much the participants would be willing to gamble for their treatment.
The study revealed that the majority of the patients, 77%, chose to take a gamble in the hopes that they would live longer than the amount of time the “sure-bet” treatment guaranteed they would live. For melanoma patients, the margin was 20% higher odds of outliving sure-bet statistics if they took the chance, for breast cancer patients it was 10%. Additionally, all of the patients were willing to pay an average of $36,000 for the possibility of living longer than guaranteed treatments allowed for. These findings suggest that people facing end of life decisions are motivated by hope. Even slim chances of longevity led to risk taking for the cancer patients surveyed here. Lakdawalla believes these results could help determine the shape of future cancer treatments. He added, “If patients care about long-term survival prospects, not just average survival, this suggests the need to incorporate long-term benefits as a unique consideration in health technology assessment for oncology treatment.”
Lakdawalla, D. N., Romley, J. A., Sanchez, Y., Ross Maclean, J., Penrod, J. R., Philipson, T. (2012). How cancer patients value hope and the implications for cost-effectiveness assessments of high-cost cancer therapies. Health Affairs, 31.4, 676-682.
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