Observational studyJournal of the National Comprehensive Cancer Network : JNCCN2020
Association Between Clinical Value and Financial Cost of Cancer Treatments: A Cross-Sectional Analysis.
Observational study in Journal of the National Comprehensive Cancer Network : JNCCN, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled 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.
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.
Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Breast cancer drugs: FDA approval, development time, efficacy, clinical benefits, innovation, trials, endpoints, quality of life, value, and price.Breast cancer (Tokyo, Japan) · 2024Pooled it
- Quality, Cost, and Timeliness of Cancer Treatment in Medicare Advantage and Traditional Medicare.JAMA internal medicine · 2026Article
- Changes in Cost of Guideline-Concordant Cancer Treatment: Observations and Implications.JCO oncology practice · 2026Article
- How often do oncologists receive industry payments from competing companies?The oncologist · 2026Article
- Provider billing margin and cancer treatment selection: population based cohort study.BMJ (Clinical research ed.) · 2025Article
- An analysis of US net cancer drug launch prices and clinical efficacy and certainty of evidence from 2008 to 2022.Health affairs scholar · 2025Article
- Quality of Treatment Selection for Medicare Beneficiaries With Cancer.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2025Article
- Prior Authorization and Association With Delayed or Discontinued Prescription Fills.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2024Article
- Launch and Post-Launch Prices of Injectable Cancer Drugs in the US: Clinical Benefit, Innovation, Epidemiology, and Competition.PharmacoEconomics · 2024Article
- FDA approval, clinical trial evidence, efficacy, epidemiology, and price for non-orphan and ultra-rare, rare, and common orphan cancer drug indications: cross sectional analysis.BMJ (Clinical research ed.) · 2023Article
- Assessment of Medical and Public Assistance Expenditures and Employment Among US Adults With Cancer Diagnoses.JAMA network open · 2023Article
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
backgroundThe cost of cancer treatment has increased significantly in recent decades, but it is unclear whether these costs have been associated with commensurate improvement in clinical value. This study aimed to assess the association between the cost of cancer treatment and 4 of the 5 NCCN Evidence Blocks (EB) measures of clinical value: efficacy of regimen/agent, safety of regimen/agent, quality of evidence, and consistency of evidence.
methodsThis is a cross-sectional, observational study. We obtained NCCN EB ratings for all recommended, first-line, and/or maintenance treatments for the 30 most prevalent cancers in the United States and calculated direct pharmacologic treatment costs (drug acquisition, administration fees, guideline-concordant supportive care medications) using Medicare reimbursement rates in January 2019. We used generalized estimating equations to estimate the association between NCCN EB measures and treatment cost with clustering at the level of the treatment indication.
resultsA total of 1,386 treatments were included. Among time-unlimited treatments (those administered on an ongoing basis without a predetermined stopping point), monthly cost was positively associated with efficacy ($3,036; 95% CI, $1,782 to $4,289) and quality of evidence ($1,509; 95% CI, $171 to $2,847) but negatively associated with safety (-$1,470; 95% CI, -$2,790 to -$151) and consistency of evidence (-$2,003; 95% CI, -$3,420 to -$586). Among time-limited treatments (those administered for a predetermined interval or number of cycles), no NCCN EB measure was significantly associated with treatment cost.
conclusionsAn association between NCCN EB measures and treatment cost was inconsistent, and the magnitude of the association was small compared with the degree of cost variation among treatments with the same EB scores. The clinical value of cancer treatments does not seem to be a primary determinant of treatment cost.
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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.