Study of lung cancer patients shows 'on-pathway' treatments save 35% of costs

A study recently conducted by US Oncology and Aetna found that evidence-based care for patients with non-small cell lung cancer (NSCLC) resulted in an average cost savings of 35% over 12 months while demonstrating equivalent health outcomes. This cost difference was driven predominately by lower costs for chemotherapy and other medications. The study, which compared patients treated with evidence-based guidelines (also known as 'on pathway') to those treated with non-evidence-based guidelines (also known as 'off pathway'), was published in the peer-reviewed Journal of Oncology Practice.

The evidence-based medicine pathways are treatment guidelines set by US Oncology's network of physicians based on evidence that has been published in peer-reviewed journals. According to US Oncology, they demonstrate treatment methods that have the best outcomes with the least harmful side effects for the majority of patients. Aetna provided data on the average payer costs for treating NSCLC patients, providing a point of comparison to determine cost savings.

“The Aetna strategy is to recognize physicians who give high quality care - defined as using pathways that speak to the best outcome for the patient and treatments that do not do more harm than good,” says Kirsten Anderson, medical director and Chief of Staff to the Chief Medical Officer at Aetna. “US Oncology’s Pathways reflect our values.”

There is limited empirical evidence regarding the cost-effectiveness of newer treatment strategies. The US Oncology and Aetna study was conducted from July 1, 2006 through Dec. 31, 2007. All NSCLC patients initiating a chemotherapy regimen at eight practices within the US Oncology Network were identified. Of a total 1,409 NSCLC patients, 1,095 (78%) were treated on pathway while 314 (22%) were treated off pathway. The cost data was provided by Aetna and the analysis was conducted from a payer's perspective and considered only direct costs. The study found no observed differences in 12-month overall survival by pathway status.

"To our knowledge, this is the first study to empirically measure the cost-effectiveness of evidence-based treatment guidelines for cancer therapy," says Roy Beveridge, M.D., medical director with US Oncology and investigator on the study. "The results suggest that treating patients according to evidence-based guidelines is a cost-effective strategy for delivering care to patients with NSCLC, especially in the adjuvant and first-line settings. We also found that there were no observed differences in outcomes, suggesting that the added cost associated with treating patients off Pathways did not translate to improved outcomes. This is a great example of cancer care that can save patients, and the nation’s health care system, millions of dollars and produce equally effective results."