Evidence map›Paper›PMID 25987701›Full record

ArticleJournal of clinical oncology : official journal of the American Society of Clinical Oncology2015

Trends in the Cost and Use of Targeted Cancer Therapies for the Privately Insured Nonelderly: 2001 to 2011.

Ya-Chen Tina Shih, Fabrice Smieliauskas, Daniel M Geynisman, Ronan J Kelly, Thomas J Smith

Open access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 84 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
84citing papers in PubMed, 4 pooled it
67.1field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

84 citing papers in PubMed, 4 syntheses or guidelines pooled it, 158 citations in OpenAlex.

  1. Pooled it
  2. Methods for measuring financial toxicity after cancer diagnosis and treatment: a systematic review and its implications.Annals of oncology : official journal of the European Society for Medical Oncology · 2019
    Pooled it
  3. Pooled it
  4. Pooled it
  5. Financial hardship experience in middle- and older-aged patients with advanced lung cancer.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2024
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  18. Oral targeted therapy for the treatment of non-small cell lung carcinoma.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2024
    Review
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  20. Article

24 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 1 institution in 1 country.

Ya-Chen Tina ShihYa-Chen Tina Shih, University of Texas MD Anderson Cancer Center, Houston, TX; Fabrice Smieliauskas, University of Chicago, Chicago, IL; Daniel M. Geynisman, Fox Chase Cancer Center, Philadelphia, PA; Ronan J. Kelly and Thomas J. Smith, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, MD. yashih@mdanderson.org.
Fabrice SmieliauskasYa-Chen Tina Shih, University of Texas MD Anderson Cancer Center, Houston, TX; Fabrice Smieliauskas, University of Chicago, Chicago, IL; Daniel M. Geynisman, Fox Chase Cancer Center, Philadelphia, PA; Ronan J. Kelly and Thomas J. Smith, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, MD.
Daniel M GeynismanYa-Chen Tina Shih, University of Texas MD Anderson Cancer Center, Houston, TX; Fabrice Smieliauskas, University of Chicago, Chicago, IL; Daniel M. Geynisman, Fox Chase Cancer Center, Philadelphia, PA; Ronan J. Kelly and Thomas J. Smith, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, MD.
Ronan J KellyYa-Chen Tina Shih, University of Texas MD Anderson Cancer Center, Houston, TX; Fabrice Smieliauskas, University of Chicago, Chicago, IL; Daniel M. Geynisman, Fox Chase Cancer Center, Philadelphia, PA; Ronan J. Kelly and Thomas J. Smith, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, MD.
Thomas J SmithYa-Chen Tina Shih, University of Texas MD Anderson Cancer Center, Houston, TX; Fabrice Smieliauskas, University of Chicago, Chicago, IL; Daniel M. Geynisman, Fox Chase Cancer Center, Philadelphia, PA; Ronan J. Kelly and Thomas J. Smith, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, MD.
Sidney Kimmel Cancer Center · US

Funding

Re-Engineering Translational Research at the University of ChicagoUL1TR000430 · NCATS · UNIVERSITY OF CHICAGO · PI SOLWAY, JULIAN · 2012 to 2016
$20.2M
Integration of Palliative Care for Cancer Patients on Phase I TrialsR01CA177562 · NCI · BECKMAN RESEARCH INSTITUTE/CITY OF HOPE · PI FERRELL, BETTY R · 2014 to 2018
$6.8M
Sustaining palliative care to drug users with HIV/AIDS & health disparitiesR01NR014050 · NINR · JOHNS HOPKINS UNIVERSITY · PI KNOWLTON, AMY · 2013 to 2017
$2.3M
Innovative methods for modeling longitudianl medical costsR01HS020263 · AHRQ · UNIVERSITY OF VIRGINIA · PI LIU, LEI · 2011 to 2015
$2.0M
Monoclonal Antibodies in Cancer Care: Is Underinsurance An Access Barrier?R01HS018535 · AHRQ · UNIVERSITY OF TX MD ANDERSON CAN CTR · PI SHIH, YA-CHEN TINA · 2009 to 2012
$1.4M
AHRQ HHS R01 HS018535AHRQ HHS R01 HS020263NCATS NIH HHS UL1 TR000430NCI NIH HHS R01 CA177562NINR NIH HHS NR014050NINR NIH HHS R01 NR014050PHS HHS P30006979
6 · The paper itself

Abstract

purposeThis study sought to define and identify drivers of trends in cost and use of targeted therapeutics among privately insured nonelderly patients with cancer receiving chemotherapy between 2001 and 2011.

methodsWe classified oncology drugs as targeted oral anticancer medications, targeted intravenous anticancer medications, and all others. Using the LifeLink Health Plan Claims Database, we studied and disaggregated trends in use and in insurance and out-of-pocket payments per patient per month and during the first year of chemotherapy.

resultsWe found a large increase in the use of targeted intravenous anticancer medications and a gradual increase in targeted oral anticancer medications; targeted therapies accounted for 63% of all chemotherapy expenditures in 2011. Insurance payments per patient per month and in the first year of chemotherapy for targeted oral anticancer medications more than doubled in 10 years, surpassing payments for targeted intravenous anticancer medications, which remained fairly constant throughout. Substitution toward targeted therapies and growth in drug prices both at launch and postlaunch contributed to payer spending growth. Out-of-pocket spending for targeted oral anticancer medications was ≤ half of the amount for targeted intravenous anticancer medications.

conclusionTargeted therapies now dominate anticancer drug spending. More aggressive management of pharmacy benefits for targeted oral anticancer medications and payment reform for injectable drugs hold promise. Restraining the rapid rise in spending will require more than current oral drug parity laws, such as value-based insurance that makes the benefits and costs transparent and involves the patient directly in the choice of treatment.

Indexed as

AdultAntineoplastic AgentsDrug CostsFemaleHealth ExpendituresHumansInsurance, Pharmaceutical ServicesMaleMiddle AgedNeoplasmsUnited StatesAntineoplastic Agents

Identifiers

PMID25987701
PMCPMC4477789
OpenAlexW2107779395

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.