Part of the FDA’s promise for PDUFA V is a more patient-centered approach to risk/benefit analysis. A timely new analysis provides a closer look at how much cancer patients value hope --with important implications for how insurers value treatment, particularly in end-of-life care.
The analysis by Darius Lakdawalla, director of research at the Schaeffer Center at USC and associate professor in the USC Price School of Public Policy, surveyed 150 cancer patients currently undergoing treatment, and is part of a special issue on cancer spending from the journal Health Affairs.
Lakdawalla and his co-authors found the overwhelming majority of cancer patients prefer riskier treatments that offer the possibility of longer survival over safer treatments: 77 percent of cancer patients said they would rather take a “hopeful gamble” — treatments that offer a 50/50 chance of either adding three years or no additional survival — to “safe bet” treatments that would keep them alive for 18 months, but no longer.
“Consumers tend to dislike risk, and researchers and policy makers have generally assumed that patients care about the average gain in survival,” Lakdawalla said. “But patients facing a fatal disease with relatively short remaining life expectancy may have less to lose and be more willing to swing for the fences. This analysis points to the larger ideal — that value should be defined from the viewpoint of the patient.”