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JNCI Journal of the National Cancer Institute 2000 92(21):1704-1706; doi:10.1093/jnci/92.21.1704
© 2000 by Oxford University Press
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Journal of the National Cancer Institute, Vol. 92, No. 21, 1704-1706, November 1, 2000
© 2000 Oxford University Press

EDITORIAL

Role of Perspective and Other Uncertainties in Cost-Effectiveness Assessments in Advanced Prostate Cancer

Bruce E. Hillner, John D. Roberts

Affiliation of authors: Department of Internal Medicine and the Massey Cancer Center, Virginia Commonwealth University, Richmond, VA.

Correspondence to: Bruce E. Hillner, M.D., Virginia Commonwealth University, Box 980170, Richmond, VA 23298-0170 (e-mail: hillner@hsc.vcu.edu).

Both its natural history and typical age at presentation make prostate cancer a disease for whose treatment the largest third-party payer is the U.S. taxpayer. Medicare payments for prostate cancer treatment were estimated to be $1.4 billion in 1994 (1). Therefore, the cost-effectiveness analysis by Bayoumi et al. (2) in this issue of the Journal, addressing three critical issues in advanced prostate cancer—medical versus surgical castration, the role of total androgen blockade with castration plus nonsteroidal antiandrogens, and the optimal timing of any of these—is timely and appropriate.

Substantial attention has been directed at potential biases in the reporting and funding of cost-effectiveness analyses of pharmaceutical agents (3,4). Identifying such biases has been easier since de facto national standards were established by the 1996 U.S. Public Health Service's Panel on Cost-effectiveness in Health and Medicine (5). This report, commissioned by . . . [Full Text of this Article]

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REFERENCES


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