The DOI matches its Crossref record; 273 of the 279 references it cites were found in a registry or an index.
Delivering affordable cancer care in high-income countries
Abstract
The burden of cancer is growing, and the disease is becoming a major economic expenditure for all developed countries. In 2008, the worldwide cost of cancer due to premature death and disability (not including direct medical costs) was estimated to be US$895 billion. This is not simply due to an increase in absolute numbers, but also the rate of increase of expenditure on cancer. What are the drivers and solutions to the so-called cancer-cost curve in developed countries? How are we going to afford to deliver high quality and equitable care? Here, expert opinion from health-care professionals, policy makers, and cancer survivors has been gathered to address the barriers and solutions to delivering affordable cancer care. Although many of the drivers and themes are specific to a particular field-eg, the huge development costs for cancer medicines-there is strong concordance running through each contribution. Several drivers of cost, such as over-use, rapid expansion, and shortening life cycles of cancer technologies (such as medicines and imaging modalities), and the lack of suitable clinical research and integrated health economic studies, have converged with more defensive medical practice, a less informed regulatory system, a lack of evidence-based sociopolitical debate, and a declining degree of fairness for all patients with cancer. Urgent solutions range from re-engineering of the macroeconomic basis of cancer costs (eg, value-based approaches to bend the cost curve and allow cost-saving technologies), greater education of policy makers, and an informed and transparent regulatory system. A radical shift in cancer policy is also required. Political toleration of unfairness in access to affordable cancer treatment is unacceptable. The cancer profession and industry should take responsibility and not accept a substandard evidence base and an ethos of very small benefit at whatever cost; rather, we need delivery of fair prices and real value from new technologies.
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“The indirect economic costs associated with premature death and lost productivity from the growing cancer burden have been estimated at US$1.16 trillion a year,3 or approaching 2% of global GDP.103”
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Metadata
- Authors
- Sullivan, R., Peppercorn, J., Sikora, K., Zalcberg, J., Meropol, N. J., Amir, E., Khayat, D., Boyle, P., Autier, P., Tannock, I. F., Fojo, T., Siderov, J., Williamson, S., Camporesi, S., McVie, J. G., Purushotham, A. D., Naredi, P., Eggermont, A., Brennan, M. F., Steinberg, M. L., De Ridder, M., McCloskey, S. A., Verellen, D., Roberts, T., Storme, G., Hicks, R. J., Ell, P. J., Hirsch, B. R., Carbone, D. P., Schulman, K. A., Catchpole, P., Taylor, D., Geissler, J., Brinker, N. G., Meltzer, D., Kerr, D., & Aapro, M.
- Affiliations
- Guy's Hospital (GB)
- Duke Medical Center (US)
- The University of Melbourne (AU)
- University Hospitals Seidman Cancer Center (US)
- University of Toronto (CA)
- Pitié-Salpêtrière Hospital (FR)
- International Prevention Research Institute (FR)
- National Cancer Institute (US)
- Austin Hospital (AU)
- Northumbria Healthcare NHS Foundation Trust (GB)
- King's College London (GB)
- European Institute of Oncology (IT)
- Umeå University (SE)
- Institut Gustave Roussy (FR)
- Memorial Sloan Kettering Cancer Center (US)
- University of California, Los Angeles (US)
- Vrije Universiteit Brussel (BE)
- Peter MacCallum Cancer Centre (AU)
- University College London (GB)
- Duke University (US)
- Vanderbilt University Medical Center (US)
- Association of the British Pharmaceutical Industry (GB)
- University of London (GB)
- Susan G. Komen Breast Cancer Foundation (US)
- University of Chicago (US)
- University of Oxford (GB)
- Clinique de Genolier (CH)
- Corresponding author
- Sullivan, Richard
- ORCID
- Sullivan, Richard
- Peppercorn, Jeffrey
- Sikora, Karol
- Zalcberg, John
- Meropol, Neal J
- Amir, Eitan
- Boyle, Peter
- Autier, Philippe
- Tannock, Ian F
- Fojo, Tito
- Siderov, Jim
- Williamson, Steve
- Camporesi, Silvia
- Purushotham, Arnie D
- Naredi, Peter
- Eggermont, Alexander
- Brennan, Murray F
- Steinberg, Michael L
- McCloskey, Susan A
- Verellen, Dirk
- Storme, Guy
- Hicks, Rodney J
- Schulman, Kevin A
- Taylor, David
- Geissler, Jan
- Meltzer, David
- Kerr, David
- Aapro, Matti
- Venue
- The Lancet Oncology
- Publisher
- Elsevier BV
- Published
- 2011-09
- Volume
- 12
- Issue
- 10
- Pages
- 933-980
- ISSN
- 1470-2045 (ISSN-L)
- OpenAlex
- W2111285159
- Cited by
- 718
- References
- 279
- Citations by year
- 2026: 21 · 2025: 24 · 2024: 34 · 2023: 16 · 2022: 33 · 2021: 43 · 2020: 40 · 2019: 32 · 2018: 60 · 2017: 45 · 2016: 56 · 2015: 67 · 2014: 75 · 2013: 81 · 2012: 76
- FWCI
- 199.54
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Lancet Oncology (publishedVersion)
- PubMed (publishedVersion)
- Strathprints: The University of Strathclyde institutional repository (University of Strathclyde) (acceptedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Research Portal (King's College London) (submittedVersion)
- VUBIR (Vrije Universiteit Brussel) (submittedVersion)
- Funders
- Conquer Cancer Foundation
- King's College Hospital NHS Foundation Trust
- National Institute for Health and Care Research
- Department of Health and Social Care
- King's College London
- Topics
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Economic and Financial Impacts of Cancer
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Advances in Oncology and Radiotherapy
- Keywords
- cancer costs, high-income countries, value-based pricing, access to cancer treatment, health equity, regulatory regimes, health policy, overuse of health care
- MeSH terms
- Australia, Cost-Benefit Analysis, Europe, Health Expenditures, Health Policy, Health Services Accessibility, Health Services Misuse, Health Services Research, Humans, Insurance, Health, Neoplasms, Socioeconomic Factors, United States, Cost Savings, Health Care Costs, Health Care Reform, Models, Economic, Delivery of Health Care, Integrated, Healthcare Disparities
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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