The Past, Current, and Future

Excerpt

According to Edgar Rice Burroughs [1], “We are, all of us, creatures of habit,” and I am foremost among this group. My days at work invariably begin with the brewing of the first of many pots of coffee, followed by a bowl of cereal while simultaneously reviewing overnight emails and submissions to the Journal of Cancer Education. My daily inbox is, I imagine much like yours, filled with urgent and not so urgent requests, anticipated responses, SPAM, updates of varying importance, and a ragtag collection of posts from various news organizations. One such post from the last category recently caught my attention. It was a story citing an IMS Health report that global cancer drug spending crossed the $100 billion threshold in 2014 [2]. (NB: this report is only concerned with cost of cancer medicines and does not include total treatment costs such as direct patient care, radiation, surgery, etc.) This represented an increase of 10.3 % from 2013 and up from $75 billion five years earlier. (NB: for thoughts on what is driving these costs, I refer you to a recent NEJM article by Avorn [3]). Spending on cancer drugs represents nearly 11 % of all drug spending globally. IMS forecast is that this will grow to $147 billion in 2018. According to GLOBOCAN [4], approximately 11 % of all cancer cases occur in the USA, yet the IMS reports that the USA accounted for 42.2 % of total spending. While I have no doubt that many of these drugs will significantly improve both the quality and length of patient lives, it does give one pause to consider whether given this level of spending on medications we are spending anywhere near enough on cancer education including training, public education, and direct patient/family educational services. …