An economic evaluation of the war on cancer
Section snippets
Framework for evaluating the war on cancer
Our analysis proceeds in three steps. First, we estimate the value to individuals of gains in cancer survival. Second, we decompose these gains into those accounted for by improved treatment and earlier detection. Finally, we estimate the aggregate social value of cancer gains, compare these to costs, and examine the distribution of gains across patients and producers. This section describes, in that order, the framework we use to answer each of these questions.
Data and methods
In the previous section, we outlined a theoretical framework for calculating the consumer surplus arising from gains in cancer survival and estimating the relative contributions of advances in cancer treatment and detection. Implementing our approach requires several pieces of information, including: (1) assumptions about the nature of the utility function, (2) estimates of stage-conditional survival and detection probabilities, (3) estimates of the income distribution, and (4) historical
Increases in cancer detection and survival after treatment
Table 1 shows changes in life expectancy and the probability of early detection between 1988 and 2000 for all cancers combined, as well as the individual tumor types of breast cancer, colorectal cancer, lung cancer, pancreatic cancer, and non-Hodgkin's lymphoma. (Note that the “all cancers combined” group also includes tumor types not individually reported in the table, such as prostate cancer.) For all cancers combined, we find that overall life expectancy increased by 3.9 years between 1988
Conclusion
Despite the abundant research documenting gains in cancer survival, there have been few attempts to characterize the value of cancer R&D. We provide some evidence relevant to this issue, by measuring the value of cancer R&D, relative to its costs. We also calculate how the social gains from R&D have been distributed between patients and producers, and the size of the respective roles played by improved treatment and earlier detection. Our findings suggest that cancer R&D has led to significant
Acknowledgements
The authors wish to thank Genentech, Inc., and the RAND Corporation's Bing Center for Health Economics for financial support. The opinions expressed herein are solely those of the authors.
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