Tuesday, March 3, 2009

Spending $6 billion more on cancer research

When the President announced his plans for health care in his budget, he announced more spending on cancer research. He talked about his personal experience and the fact that nearly everyone has known someone who is affected by cancer. Providing an additional $6 billion funding for the National Cancer Institute has the potential to relieve a lot of suffering in the long run. The key question is whether this is a good way to spend the money--even if it is "only" $6 billion which seems like a drop in a much bigger bucket at this point in time.

To determine whether it is a good expenditure, we have to ask questions like:

What else could be done with the money?
For how many people will cancer be prevented, found earlier, or treated better?
How much of a difference will it make for those patients?
Will the new treatment/prevetion cost more than what is already available?

There are plenty of other things that could be done with the money--but that is always true. For $6 billion you could insure between 500,000 and 1,000,000 people for one year. We could also implement a number of public health progams that could be implemented aiming at the entire population for that price. Either of those options could have powerful short run effects but likely would not have the same long run effects as a spending money on cancer-related research.

The bigger concern is that cancer is only one type of disease. It affects many peopel and it is a important disease--but so are many others.

There are many ways that patients' quality of life could be improved by preventing cancer, identifying it earlier, or treating it more successfully. But the same could be said of many other conditions.

Finally, many new treatments are more expensive than old ones and may not be immediately cost-effective. If the findings from the proposed increase in reserach do turn out to be important clinical findings--will we have enough money available in the budget to support the implementation of the type of care?

I am not suggesting that we are spending the right amount on research now. I am only suggesting that as we allocate increased resources we consider the balance between (1) using resources for basic research on new prevention, identification, and treatment strategies that will help in the long run (which tends to be what is done at NCI) and (2) using resources to find more efficient ways to provide patient care technologies we already have in the short run.

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