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Promise and Progress - Cost-Cutting and Excellent Care Not Mutuallly Exclusive

Reprogramming Cancer Cells - The Story of Epigenetics
Issue No. 1

Cost-Cutting and Excellent Care Not Mutuallly Exclusive

Date: July 16, 2014


Lancet Oncology, February 2014

Cost-cutting strategies in end-of-life care, medical imaging, and drug pricing could significantly reduce healthcare expenses without harming patients, a study by Kimmel Cancer Center experts finds. 

Thomas Smith, M.D., the Harry J. Duffey Family Professor in Palliative Care, and Ronan Kelly, M.D., recommend hospice care rather than hospitalization for end-of-life care.  Hospice care improves symptoms, is associated with equal or better survival, helps caregivers, and costs less, Dr. Smith says. Yet, they report, just 50 percent of cancer patients used hospice in their last month of life. About 25 percent of Medicare costs are spent in the last month of life, so Drs. Smith and Kelly recommend more substantive and earlier discussions between patients and physicians related to chemotherapy and other hospital-based care at the end of life.  The researchers also found that expensive imaging is often used to monitor for cancer recurrence or progression when it could be detected through other examinations.

A cost-benefit analysis of cancer drugs also was recommended.

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