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Cost-benefit analysis: Combo treatment costs more, saves money later

From a health insurer's perspective, the most effective cancer treatment may also be the most cost-effective, according to a new study sponsored by the Radiation Therapy Oncology Group (RTOG 91-11).

Compared to higher-priced combination treatments, the least expensive, single-modality cancer treatment may cost more in the long run because of the costs associated with treating complications and recurrence of cancer, said lead author Andre A. Konski, M.D., M.B.A., M.A., a radiation oncologist and director of clinical research in Fox Chase Cancer Center's radiation oncology department. Konski presented the results today at the 48th Annual Meeting of the American Society for Therapeutic Radiology and Oncology in Philadelphia.

The study examined costs for patients with Medicare insurance who had taken part in an RTOG clinical trial, #9111, for locally advanced laryngeal cancer between 1991 and 1996. That randomized phase III trial was designed to compare three treatment regimens--two combining radiation therapy and chemotherapy and one using only radiation therapy.

"In overall survival rates, there was no significant difference among the three treatment arms," Konski pointed out. "However, patients receiving induction chemotherapy as well as radiation or concurrent chemo-radiation therapy had better outcomes in terms of disease-free survival, local and regional control and preservation of their larynx.

"In our subsequent economic analysis," Konski explained, "these better outcomes translated into significant savings of dollars that were spent on treating patients for complications and recurrences that occurred with the less effective therapy of radiation by itself."

The specific aim of the new RTOG cost-benefit analysis was to evaluate the cost-effectiveness of the combination chemotherapy and radiation treatments compared to radiation therapy alone as viewed from the payer's perspective. Of the 547 patients who took part in RTOG 9111, Med
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Contact: Karen Mallet
karen.mallet@fccc.edu
215-728-2700
Fox Chase Cancer Center
7-Nov-2006


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