This month’s issue of Health Affairs examines a range of cancer-related topics, with a special focus on the value of high-cost cancer treatments. Though the issue explores a variety of emerging research on access to cancer care, one study on value has gained increased attention in the blogosphere. “An Analysis of Whether Higher Health Care Spending in The United States Versus Europe is ‘Worth It’ in the Case of Cancer,” led by Tomas Philipson of the University of Chicago, looks at U.S. cancer care costs and survival differences compared with those of 10 European countries. The authors conclude that though the United States spends more, the patients in the study period lived longer, thus making the cost of care “worth it.” But some critics have jumped in to say that the study design is flawed, noting that looking at “survival rate” versus “mortality rate” doesn’t account for lead-time bias. There’s been an interesting discussion of those measures going on over at The Incidental Economist. In this morning’s Health Affairs briefing, Dana Goldman of the Leonard D. Schaeffer Center—who was filling in for Philipson—stated that better mortality rates in United States show that longer U.S. survival is not just from earlier diagnosis. This month’s issue is also full of work from AcademyHealth members, including: How Cancer Patients Value Hope and The Implications for Cost-Effectiveness Assessments of High-Cost Cancer Therapies J. Ross Maclean Patients Value Metastatic Cancer Therapy More Highly Than Is Typically Shown Through Traditional Estimates  J. Ross Maclean Therapies for Advanced Cancers Pose a Special Challenge for Health Technology Assessment Organizations in Many Countries  Peter J. Neumann In a Survey, Marked Inconsistency in How Oncologists Judged Value of High-Cost Cancer Drugs in Relation to Gains in Survival  Jennifer A. Palmer and Peter J. Neumann Appropriate and Inappropriate Imaging Rates for Prostate Cancer Go Hand in Hand by Region, as if Set by Thermostat Danil V. Makarov, Harlan M. Krumholz, and David F. Penson Urologists’ Self-Referral for Pathology of Biopsy Specimens Linked to Increased Use and Lower Prostate Cancer Detection  Jean M. Mitchell Growth of High-Cost Intensity-Modulated Radiotherapy for Prostate Cancer Raises Concerns About Overuse  Yun Zhang, Ted A. Skolarus, and Brent K. Hollenbeck THE CARE SPAN: End-Of-Life Care for Medicare Beneficiaries with Cancer is Highly Intensive Overall and Varies Widely Chiang-Hua Chang, Julie P.W. Bynum, and David C. Goodman Medicare’s Flagship Test of Pay-For-Performance did not Spur more Rapid Quality Improvement among Low-Performing Hospitals  Andrew M. Ryan, Jan Blustein, and Lawrence P. Casalino Lower Mortality Rates at Cardiac Specialty Hospitals Traceable to Healthier Patients and to Doctors’ Performing More Procedures Liam O’Neill Hospitals’ Geographic Expansion in Quest Of Well-Insured Patients: Will the Outcome be Better Care, More Cost, or Both? Robert A. Berenson Consumers’ and Providers’ Responses to Public Cost Reports, and How to Raise the Likelihood of Achieving Desired Results  Ateev Mehrotra, Peter S. Hussey, and Judith H. Hibbard Living Life in My Own Way—And Dying That Way as Well Amy Berman Risk Sharing and Aligning Incentives: The Authors Reply  Peter J. Neumann Health Affairs is an official journal of AcademyHealth.

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