Cost differential of chemotherapy for solid tumors

Abstract

Purpose: A significant portion of national cancer expenditure is attributed to chemotherapy. Although the National Comprehensive Cancer Network has generated recommendations for the treatment of various solid tumors, the outlined chemotherapeutic strategies lack information about the cost differential for increasing effectiveness. Methods: Chemotherapy regimens (curative [adjuvant/neoadjuvant] and metastatic therapy) and dosages outlined in the 2013 National Comprehensive Cancer Network guidelines were acquired for four common cancers: bladder, breast, colon, and lung. Baseline drug and treatment costs (inUSdollars)were calculated for the averageUSadult maleonthe basis of the payment allowance in the 2013 Medicare Part B average sales price (ASP) drug pricing files. Costs were extrapolated for a treatment period of 6 months. Results: Of the 62 regimens included, the 6-month mean cost of chemotherapy was $26,989 ± $29,971, and the median costwas $9,611 (interquartile range, $6,305-$39,383). Themean cost of metastatic cancer therapy regimens (n = 32) was $35,315632,962 compared with $18,107 ± 23,873 for curative therapy (P =.02). Of the 13 regimens with biologics used, the mean costs were $77,278 versus $13,646 for 49 regimens that did not use biologics (P