19 Feb Chemotherapy in last months of life associated with higher estimated health care costs

MedicalResearch.com Interview with:

Dr. Melissa Garrido

Melissa Garrido, PhD
Assistant Professor / Research Health Science Specialist
GRECC, James J Peters VA Medical Center, Bronx, NY
Brookdale Department of Geriatrics & Palliative Medicine
Icahn School of Medicine at Mount Sinai, New York, NY

Medical Research: What is the background for this study? What are the main findings?

Response: Medical costs for people with serious illnesses are rapidly rising in the United States. Concerns about medical debt and bankruptcy are especially relevant when deciding whether to begin or maintain a treatment that may have limited benefit to a patient’s survival or quality of life. Among patients with advanced cancer, one such decision is the choice of whether to use additional chemotherapy when the disease has not responded to an initial line or lines of chemotherapy. In this study, we used data from a prospective study of patients with advanced cancer and their caregivers to examine the relationship between chemotherapy use at study entry (median of four months before death) and estimated costs of healthcare other than chemotherapy in the last week of life.

Medical Research: What is the background for this study? What are the main findings?

Dr. Garrido: Among patients with end-stage cancer, those who received chemotherapy in the months before death had higher estimated costs of care in the last week of life.  We did not find evidence that this relationship was explained by patients’ preferences for care, do-not-resuscitate orders, or discussions of care preferences.

Medical Research: What should clinicians and patients take away from your report?

Dr. Garrido: Clinicians and patients may wish to discuss the potential financial implications of treatment decisions when it is unclear that a treatment will have a clinical benefit.

Medical Research: What recommendations do you have for future research as a result of this study?

Dr. Garrido: Future studies should examine actual costs incurred and should explore whether the estimated costs of care observed in our study may be attributed to care to treat side effects of chemotherapy or differences in physicians’ practice patterns.

The views expressed are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs or the United States government or the Editors of MedicalResearch.com.

Citation:

Chemotherapy Use in the Months Before Death and Estimated Costs of Care in the Last Week of Life

Melissa M. Garrido, PhD Holly G. Prigerson, PhD 
Yuhua Bao, PhD Paul K. Maciejewski, PhD

DOI: http://dx.doi.org/10.1016/j.jpainsymman.2015.12.323

Journal of Pain and Symptom Management

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Melissa Garrido, PhD (2016). Chemotherapy In Last Months of Life Raises Overall Health Care Costs 

Last Updated on February 20, 2016 by Marie Benz MD FAAD