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Journal of the National Cancer Institute Advance Access published online on June 29, 2009
JNCI Journal of the National Cancer Institute, doi:10.1093/jnci/djp177
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Published by Oxford University Press 2009.

COMMENTARY

How Much Is Life Worth: Cetuximab, Non–Small Cell Lung Cancer, and the $440 Billion Question

Tito Fojo, Christine Grady

Affiliations of authors: Medical Oncology Branch, Center for Cancer Research, National Cancer Institute (TF), and Department of Bioethics, The Clinical Center (CG), National Institutes of Health, Bethesda, MD

Correspondence to: Tito Fojo, MD, PhD, Medical Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bldg 10, Rm 12 N226, 9000 Rockville Pike, Bethesda, MD 20892 (e-mail: tfojo{at}helix.nih.gov).

The spiraling cost of cancer care, in particular the cost of cancer therapeutics that achieve only marginal benefits, is under increasing scrutiny. Although health-care professionals avoid putting a value on a life, our limited resources require that society address what counts as a benefit, the extent to which cost should factor in deliberations, and who should be involved in these decisions. Professional societies, such as the American Society of Clinical Oncology, government agencies, including the Food and Drug Administration, and insurance companies should be involved. However, no segment of society is better qualified to address these issues than the oncology community. Oncologists must offer clear guidance for the conduct of research, interpretation of results, and prescription of chemotherapies. We review recent drug approvals and clinical trials and comment on their relevance to the issue of the spiraling cost of oncology therapeutics. We suggest some standards that would serve as a starting point for addressing these issues.

Manuscript received November 18, 2008; revised April 30, 2009; accepted May 19, 2009.


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