American Society of Clinical Oncology Guidance Statement: The Cost of Cancer Care
American Society of Clinical Oncology Guidance Statement: The Cost of Cancer Care
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DOI：
10.1200/jco.2009.23.1183
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发表时间：
2009-08-10
影响因子：
45.3
通讯作者：
Schnipper, Lowell E.
中科院分区：
文献类型：
--
作者：
Meropol, Neal J.;Schrag, Deborah;Schnipper, Lowell E.
早期发现、预防和治疗的进步导致美国癌症死亡率持续下降。与这些进步同时出现的是癌症护理成本的显著增加。众所周知，美国的医疗保健（包括癌症护理）成本增长速度快于整体经济。部分原因是新药剂和其他技术的价格和快速吸收，包括成像和治疗放射学的进步。传统的理解认为，高价格可能反映了与新药和新技术的开发、生产和营销相关的成本和风险，其中许多新药和新技术受到医生、患者和付款人的高度重视。癌症护理成本的增加影响了在复杂的医疗保健系统中发挥作用的许多利益相关者。我们的病人是最脆弱的，因为他们经常经历不均衡的保险覆盖范围，导致财务紧张，甚至破产。其他关键群体包括将研究、开发和营销成本沿着给消费者的制药商;分发越来越昂贵的药物和技术的癌症护理提供者;以及最终将成本转嫁给消费者的保险业。越来越多的美国人将越来越负担不起医疗保健的经济负担，特别是高质量的癌症护理，除非采取措施遏制目前的趋势。美国临床肿瘤学会（ASCO）致力于改善癌症预防、诊断和治疗，并通过支持循证和具有成本效益的实践来消除癌症护理中的差异。为了实现这一目标，ASCO成立了一个护理成本工作组，该工作组制定了癌症护理成本指导声明。本指导声明提供了癌症社区利益相关者面临的经济问题的简要概述。它还建议采取以下步骤来解决眼前的需要：认识到病人和医生之间关于护理费用的讨论是高质量护理的一个重要组成部分;为肿瘤学提供者设计教育和支持工具，以促进与病人就费用问题进行有效沟通;以及开发资源来帮助教育患者关于癌症护理的高成本，以帮助指导他们关于治疗选择的决策。展望未来，该指导声明还建议ASCO制定政策立场，以解决导致癌症护理成本增加的潜在因素。这样做将需要清楚地了解导致这些成本的因素，以及对当前癌症护理系统的潜在修改，以确保所有美国人都能获得高质量，具有成本效益的护理。
Advances in early detection, prevention, and treatment have resulted in consistently falling cancer death rates in the United States. In parallel with these advances have come significant increases in the cost of cancer care. It is well established that the cost of health care (including cancer care) in the United States is growing more rapidly than the overall economy. In part, this is a result of the prices and rapid uptake of new agents and other technologies, including advances in imaging and therapeutic radiology. Conventional understanding suggests that high prices may reflect the costs and risks associated with the development, production, and marketing of new drugs and technologies, many of which are valued highly by physicians, patients, and payers. The increasing cost of cancer care impacts many stakeholders who play a role in a complex health care system. Our patients are the most vulnerable because they often experience uneven insurance coverage, leading to financial strain or even ruin. Other key groups include pharmaceutical manufacturers that pass along research, development, and marketing costs to the consumer; providers of cancer care who dispense increasingly expensive drugs and technologies; and the insurance industry, which ultimately passes costs to consumers. Increasingly, the economic burden of health care in general, and high-quality cancer care in particular, will be less and less affordable for an increasing number of Americans unless steps are taken to curb current trends. The American Society of Clinical Oncology (ASCO) is committed to improving cancer prevention, diagnosis, and treatment and eliminating disparities in cancer care through support of evidence-based and cost-effective practices. To address this goal, ASCO established a Cost of Care Task Force, which has developed this Guidance Statement on the Cost of Cancer Care. This Guidance Statement provides a concise overview of the economic issues facing stakeholders in the cancer community. It also recommends that the following steps be taken to address immediate needs: recognition that patient-physician discussions regarding the cost of care are an important component of high-quality care; the design of educational and support tools for oncology providers to promote effective communication about costs with patients; and the development of resources to help educate patients about the high cost of cancer care to help guide their decision making regarding treatment options. Looking to the future, this Guidance Statement also recommends that ASCO develop policy positions to address the underlying factors contributing to the increased cost of cancer care. Doing so will require a clear understanding of the factors that drive these costs, as well as potential modifications to the current cancer care system to ensure that all Americans have access to high-quality, cost-effective care.