Variation in prostate cancer treatment and spending among Medicare shared savings program accountable care organizations

Modi, Parth K.; Kaufman, Samuel R.; Borza, Tudor; Yan, Ping; Miller, David C.; Skolarus, Ted A.; Hollingsworth, John M.; Norton, Edward C.; Shahinian, Vahakn B.; Hollenbeck, Brent K.

doi:10.1002/cncr.31573

Cited by 10 publications

(9 citation statements)

References 25 publications

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“…For advanced PCa, more aggressive treatment measures are taken, represented by androgen deprivation therapy (ADT) for metastatic PCa and docetaxel and prednisolone for castration-resistant PCa (25,26). Potential side effects from treatment may be one of the reasons for this phenomenon (27,28). The spectrum of cause of death also changed more significantly with increased follow-up time.…”

Section: Discussionmentioning

confidence: 99%

Causes of Death Among Prostate Cancer Patients Aged 40 Years and Older in the United States

Zheng

Miao

et al. 2022

Front. Oncol.

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PurposeLittle is known about the detailed spectrum of the cause of death associated with prostate cancer (PCa). This study systematically characterized the cause of death among patients with PCa.MethodsPatients aged 40 years and older with primary PCa were identified from the Surveillance, Epidemiology, and End Results program. Mortality rates were estimated. Standardized mortality ratios (SMRs) of non-cancer deaths were calculated to evaluate the risk of death and to compare with the cancer-free population.ResultsThis study included 1,170,489 patients with PCa. There were 501,262 deaths, of which 27.4% were due to PCa and 57.0% were due to non-cancer causes. Non-cancer deaths increased over time from 1975 to 2016, and index cancer death decreased continually. The risk of non-cancer deaths was 1.45 times (SMR, 1.45; 95% confidence interval [CI], 1.45–1.46) that of the general population. Cardiovascular disease was the most common non-cancer cause of death, accounting for 30.2% of all deaths among PCa patients. Alzheimer’s disease (SMR, 3.92; 95% CI, 3.85–4.00) had the highest risk of death. The mortality rate and SMR of non-cancer deaths increased with increased follow-up after diagnosis.ConclusionInstead of the index cancer, non-cancer comorbidities were the leading cause of death among patients with PCa, and the risk of non-cancer deaths was much higher than among the general population. Clinicians and researchers should be aware of this trend to conduct timely and targeted interventions.

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Section: Discussionmentioning

confidence: 99%

Causes of Death Among Prostate Cancer Patients Aged 40 Years and Older in the United States

Zheng

Miao

et al. 2022

Front. Oncol.

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“… 33 Modi et al reported that stronger engagement of urologists in accountable care organizations was associated with a lower likelihood of potential overtreatment (odds ratio: .29; 95% confidence interval: .10-.86) in the US. 34 Shi et al compared the cost-effectiveness of 6 common cancers from a priority setting perspective. Their preliminary analysis suggested that stomach cancer and colorectal cancer were the most cost-effective target cancers, and they concluded that they can be prioritized in future scaled-up screening in the general population.…”

Section: Discussionmentioning

confidence: 99%

Forecasting of Future Medical Care Expenditure in Japan Using a System Dynamics Model

Inoue¹,

Maswana

et al. 2022

INQUIRY

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Background The aim of this study was to construct a system dynamics (SD) model to estimate the future medical care expenditure and to address the dynamic issues of health care that should be resolved. In particular, the measures for promoting the spread of generic drug (GE drug) usage in Japan and reducing cancer-related medical expenses were investigated regarding their future impact on medical finances. Methods The SD model was constructed from FY 2018 to FY 2050. The change in the future GE drug quantity share was analyzed by using a regression equation. The impact of the increase in medical expense for cancer and the change in the future national medical care expenditure were also estimated. Results The annual total medical care expenditure in FY 2050 would arrive at 58.9–64.2 trillion JPY (US$ 535.1–584.0 billion) (1.3–1.5 times higher than that in FY 2018) with different trends in age groups. The cumulative total medical care expenditure was expected to decrease by about 787.0–989.4 billion JPY (US$ 7.2–9.0 billion) if the impact of the spread of GE drug usage was considered. On the other hand, due to the continuous increase in the cancer-related medical expense, the cumulative total medical care expenditure was estimated to increase about 7554.3–11715.0 billion JPY (US$ 68.7–106.5 billion). Conclusions If the cancer-related medical expense continues to increase in the future, an increase of 686.4–1104.2 billion JPY (US$ 6.2–10.0 billion) in FY 2050 is expected which suggests that this disease field should be prioritized regarding the measures to maintain medical finances.

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“…For example, Kuipers et al investigated the relationship between mass media campaigns for smoking cessation and the success rate of quit attempts, and found that an increase in mass media expenditure of 10% of the monthly average was associated with a 0.51% increase in success rates of quit attempts (95% CI 0.10-0.91%) [30]. Holleman et al evaluated the impact of alternative risk-sharing arrangements (RSAs) for non-small cell lung cancer therapies based on real-world data and concluded that RSAs can mitigate uncertainty around the incremental cost-effectiveness or budget impact of drugs [31]. Modi et al reported that stronger engagement of urologists in accountable care organizations was associated with a lower likelihood of potential overtreatment (odds ratio: 0.29; 95% con dence interval: 0.10-0.86) in the US [32].…”

Section: Discussionmentioning

confidence: 99%

Forecasting of Future Medical Care Expenditure in Japan Using a System Dynamics Model

Inoue¹,

Maswana

et al. 2021

Preprint

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Background:Japanese society is facing marked changes due to the aging population and concomitant rapid increase in the national medical care expenditure. To maintain a sustainable national health insurance system, it is important to pursue the efficient allocation of medical care resources. The aim of this study was to construct a system dynamics (SD) model to estimate the future medical care expenditure and to address the dynamic issues of health care that should be resolved. In particular, the measures for promoting the spread of generic drug (GE drug) usage in Japan and reducing cancer-related medical expenses were investigated regarding their future impact on medical finances.Methods:The SD model was constructed to estimate the medical care expenditure from FY 2018 to FY 2050. The change in the future GE drug quantity share was analyzed by using a regression equation, and the target value of the GE quantity share was set exceeding 90% by referring to trends in other countries. The impact of the increase in medical expense for cancer and the change in the future national medical care expenditure were also estimated assuming the current tendency of increase in the medical expense for cancer continues.Results:It was estimated that the annual total medical care expenditure in FY 2050 would arrive at 58.9–64.2 trillion JPY (1.3-1.5-times higher than that in FY 2018) with different trends in age groups. The cumulative total medical care expenditure was expected to decrease by about 787.0-989.4 billion JPY if the impact of the spread of GE drug usage was considered. On the other hand, due to the continuous increase in the cancer-related medical expense, the cumulative total medical care expenditure was estimated to increase about 7,554.3–11,715.0 billion JPY.Conclusions:If the cancer-related medical expense continues to increase in the future, an increase of 686.4-1,104.2 billion JPY in FY2050 is expected which suggests that this disease field should be prioritized regarding the measures to maintain medical finances. This study may serve as a reference for designing a policy in countries that will enter a super-aging society in the future such as that in Japan.Trial registration: Not applicable

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Variation in prostate cancer treatment and spending among Medicare shared savings program accountable care organizations

Cited by 10 publications

References 25 publications

Causes of Death Among Prostate Cancer Patients Aged 40 Years and Older in the United States

Causes of Death Among Prostate Cancer Patients Aged 40 Years and Older in the United States

Forecasting of Future Medical Care Expenditure in Japan Using a System Dynamics Model

Forecasting of Future Medical Care Expenditure in Japan Using a System Dynamics Model

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