Get 20M+ Full-Text Papers For Less Than $1.50/day. Start a 14-Day Trial for You or Your Team.

Learn More →

Introduction to the Supplement: Is Now the Time for the Future of Cancer Economics Research?

Introduction to the Supplement: Is Now the Time for the Future of Cancer Economics Research? Abstract The National Cancer Institute’s Division of Cancer Control and Population Sciences hosted a virtual conference, The Future of Cancer Health Economics Research, in December 2020. This conference brought together a multidisciplinary group of researchers and other stakeholders interested in supporting and developing the field of cancer health economics research to help improve both patient outcomes and health-care systems. The introduction to the supplement describes the origins and planning for the conference and the conference sessions and presentations. The papers included in this supplement, arising from the conference sessions, help strengthened our understanding of what is cancer health economics research and how this field can provide even greater contributions in the future. There have been tremendous advances in cancer prevention, screening, treatment, and survivorship care over the past few decades, leading to substantial improvements in survival following diagnosis. The number of cancer survivors in the United States has increased from 7 million in 1992 to more than 15 million in 2016 and is anticipated to increase to more than 26 million by 2040 (1). However, improved outcomes resulting from cancer care can be associated with substantial costs. Mariotto et al. (2) reported that medical care costs for those diagnosed with cancer in the United States were approximately $183 billion in 2015 and are projected to increase to $240 billion by 2030. Individuals may experience substantial out-of-pocket costs well after their acute cancer treatment has been completed. For example, a 2014 study of long-term breast cancer survivors reported that 18% had annual out-of-pocket costs of $2100-$5000, and an additional 17% had annual costs greater than $5000 (3). Cancer health economics research can broadly be described as a field that examines the relationships between economic factors and cancer-related health outcomes. In 2019, there was increasing interest in how the National Cancer Institute (NCI) could better support the field of cancer health economics research. This rapidly developed to the larger question: how should the field of cancer health economics research grow and develop? Addressing this question required wide-ranging input from stakeholders across the cancer control continuum. Multiple perspectives, including those from researchers, clinicians, patients, caregivers, patient advocates, and policy makers, from a range of organizations were needed. To bring everyone together, a natural approach was to hold a conference, optimistically (if somewhat presumptuously) called The Future of Cancer Health Economics Research. Leadership of the NCI Division of Cancer Control and Population Sciences (DCCPS), the Healthcare Delivery Research Program, and the Healthcare Assessment Research Branch was extremely supportive of this conference. Conference planning began with a core group: myself, Donatus “Don” Ekwueme from the Centers for Disease Control and Prevention, Ya-Chen Tina Shih from the University of Texas MD Anderson Cancer Center, and Robin Yabroff from the American Cancer Society. We quickly decided the conference should not simply be a summary of existing research but should focus on actionable steps for moving the field of cancer health economics research forward. The core goals of the conference would be: Identify challenges, gaps, and unmet needs for conducting cancer health economics research Develop suggestions and ideas to address the identified challenges and to support the further development of this field Multiple individuals inside and outside of NCI provided encouragement, feedback, support, and ideas for the conference. Originally planned as an in-person meeting for July 2020, we pivoted to a virtual conference held December 2-3, 2020, because of the COVID-19 pandemic. This change to a virtual event was initially disappointing, however, it allowed for greater participation by many individuals who might not otherwise have attended the conference. Conference planning involved 3 parallel tracks: organizing committees; panels and breakout sessions; and preconference activities. Four organizing committees were formed in alignment with the cancer control continuum: Prevention (led by Donatus Ekwueme), Screening/Diagnosis (led by Ya-Chen Tina Shih), Treatment (led by Robin Yabroff), and Survivorship (led by Cathy Bradley from the University of Colorado). Each organizing committee was responsible for considering the conference goals (challenges for conducting cancer health economics research and suggestions to move the field forward) within its specific area of the cancer control continuum. Based on these deliberations, each committee developed a brief conference presentation designed to summarize the current state of research within its area and to stimulate an interactive discussion among online participants. In parallel, individuals who had expressed interest in this conference were contacted to elicit suggestions for panels and breakout sessions. Joe Lipscomb from Emory University suggested an ideal framework for the panels, What do we need to succeed? That is, what does the field of cancer health economics research need to grow and flourish in the future? Using this framework, we identified 3 panel topics: Communicating health economics research to nonresearcher audiences, led by Yousuf Zafar of Duke University New data infrastructures, resources, and linkages, led by Scott Ramsey of University of Washington Conducting cancer health economics research with a goal of enhancing health equity, co-led by Cathy Bradley and Karen Winkfield of the Meharry-Vanderbilt Alliance Multiple individuals also provided suggestions for conference breakout sessions (and volunteered to lead or co-lead sessions). These were named Action Breakout Sessions, to emphasize their goal of identifying actionable next steps to enhance cancer health economics research. Four such sessions were held at the conference: Development, organization, and structure of training programs for cancer health economics research, co-led by Oliver Bogler of NCI’s Center for Cancer Training, Lindsay Sabik of the University of Pittsburgh, and Courtney Williams of NCI’s Cancer Prevention Fellowship Program Fostering interdisciplinary and transdisciplinary collaborations in cancer health economics research, co-led by Gila Neta of NCI DCCPS and James Yu of Yale University Improving data accessibility for health economics research without compromising data security, co-led by Michael Pesko of Georgia State University and Debra Ritzwoller of Kaiser Permanente Institute for Health Research Methods and study design for cancer health economics research, co-led by Henry (Joe) Henk of OptumLabs and Ya-Chen Tina Shih With the outpouring of ideas and enthusiasm for breakout sessions, we also scheduled networking discussions sessions as part of the conference. These were opportunities to meet (virtually) with other conference attendees sharing interest in a specific topic, similar to meeting with a group of colleagues in a hallway during an in-person meeting. Five informal networking discussions sessions were scheduled: Creating a data warehouse, led by Henry (Joe) Henk Data linkages, led by Lindsey Enewold of NCI DCCPS Employment outcomes, financial hardship, and caregiver economic burden in cancer, co-led by Janet de Moor of NCI DCCPS and Victoria Blinder of Memorial Sloan Kettering Cancer Center Implementation science and health economics, co-led by Gila Neta of NCI DCCPS and Heather Gold of New York University The health economics of end-of-life and palliative care: building a research agenda, led by Jeri Miller of the National Institute of Nursing Research While the conference planning was underway, 3 preconference activities were also initiated. First, to better understand NCI’s recent activities supporting cancer health economics research, Priyanga Tuovinen and Sharon McCarthy of the NCI DCCPS and myself performed a portfolio review of NCI-funded grants that included economic analysis. Details of this portfolio review are presented as a separate paper in this supplement. Also, to better understand the broad landscape of cancer health economics research, Amy Davidoff of the NCI DCCPS, in collaboration with Katie Akif (a presidential management fellow at NCI) and myself, conducted a meta-review summarizing published review articles in this field. Details of this meta-review are also presented as a separate paper in this supplement. The conference agenda and recordings from many of the sessions are available at https://healthcaredelivery.cancer.gov/heroic/conference.html. Finally, in the course of planning the conference, it became clear that cancer health economics research had different meanings to different researchers. For the conference, it would be useful to have common domains and scope for discussions of this field. A small group of individuals collaborated to prepare a framework for cancer health economics research. This group intentionally did not try to create a set definition for this field; rather, the group hoped to develop a working structure to help identify topics and research questions of greatest interest to the conference. This framework was published in Cancer the week prior to the conference (4). This framework illustrates key economic inputs for cancer health economics research across the cancer control continuum; patient, payer, provider, health-care system, and societal-level outcomes frequently considered in cancer health economics research; and structural and policy factors that influence the relationship between these input and outputs. A key take-away from this framework is that the field of cancer health economics research includes but extends well beyond examination of costs and cost-effectiveness. This field incorporates the impacts of policies, programs, and multiple factors on cancer-related services as well as the role of economic factors on health equity, quality of care, and patient outcomes related to cancer. The breadth and diversity of cancer health economics research is reflected in the conference agenda (described above) and the multiple papers included in this supplement. This supplement represents a unique collaborative effort, bringing together a remarkable group of individuals with shared interests in enhancing cancer health economics research to help improve both patient outcomes and the health-care system broadly. The NCI-hosted Future of Cancer Health Economics Research virtual conference was an important step to plan approaches for enhancing the critical role of this field across the cancer control continuum. Thanks to the dedication of all those who supported and participated in this conference and related activities, including this supplement, we have strengthened our understanding of what is cancer health economics research, what has been achieved to date, and how this field can develop to provide even greater contributions in the future. Funding None. Notes Role of the funder: No funding was received for this study and the author indicates no conflicts of interest. Disclaimers: The views expressed here are those of the author do not necessarily represent any official position of the National Cancer Institute or National Institutes of Health. References 1 National Cancer Institute. National Cancer Institute overview and mission. https://www.cancer.gov/about-nci/overview. Accessed July 29, 2021 . 2 Mariotto AB , Enewold L, Zhao J, et al. Medical care costs associated with cancer survivorship in the United States . Cancer Epidemiol Biomarkers Prev . 2020 ; 29 ( 7 ): 1304 – 1312 . Google Scholar Crossref Search ADS PubMed WorldCat 3 Jagsi R , Pottow JA, Griffith KA, et al. Long-term financial burden of breast cancer: experiences of a diverse cohort of survivors identified through population-based registries . J Clin Oncol . 2014 ; 32 ( 12 ): 1269 – 1276 . Google Scholar Crossref Search ADS PubMed WorldCat 4 Halpern MT , Shih YT, Yabroff KR, et al. A framework for cancer health economics research . Cancer . 2021 ; 127 ( 7 ): 994 – 996 . Google Scholar Crossref Search ADS PubMed WorldCat Published by Oxford University Press 2022. This work is written by (a) US Government employee(s) and is in the public domain in the US. This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model) Published by Oxford University Press 2022. This work is written by (a) US Government employee(s) and is in the public domain in the US. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png JNCI Monographs Oxford University Press

Introduction to the Supplement: Is Now the Time for the Future of Cancer Economics Research?

JNCI Monographs , Volume 2022 (59) – Jul 5, 2022

Loading next page...
 
/lp/oxford-university-press/introduction-to-the-supplement-is-now-the-time-for-the-future-of-OybaYQWH63
Publisher
Oxford University Press
Copyright
Copyright © 2022 Oxford University Press
ISSN
1052-6773
eISSN
1745-6614
DOI
10.1093/jncimonographs/lgab017
Publisher site
See Article on Publisher Site

Abstract

Abstract The National Cancer Institute’s Division of Cancer Control and Population Sciences hosted a virtual conference, The Future of Cancer Health Economics Research, in December 2020. This conference brought together a multidisciplinary group of researchers and other stakeholders interested in supporting and developing the field of cancer health economics research to help improve both patient outcomes and health-care systems. The introduction to the supplement describes the origins and planning for the conference and the conference sessions and presentations. The papers included in this supplement, arising from the conference sessions, help strengthened our understanding of what is cancer health economics research and how this field can provide even greater contributions in the future. There have been tremendous advances in cancer prevention, screening, treatment, and survivorship care over the past few decades, leading to substantial improvements in survival following diagnosis. The number of cancer survivors in the United States has increased from 7 million in 1992 to more than 15 million in 2016 and is anticipated to increase to more than 26 million by 2040 (1). However, improved outcomes resulting from cancer care can be associated with substantial costs. Mariotto et al. (2) reported that medical care costs for those diagnosed with cancer in the United States were approximately $183 billion in 2015 and are projected to increase to $240 billion by 2030. Individuals may experience substantial out-of-pocket costs well after their acute cancer treatment has been completed. For example, a 2014 study of long-term breast cancer survivors reported that 18% had annual out-of-pocket costs of $2100-$5000, and an additional 17% had annual costs greater than $5000 (3). Cancer health economics research can broadly be described as a field that examines the relationships between economic factors and cancer-related health outcomes. In 2019, there was increasing interest in how the National Cancer Institute (NCI) could better support the field of cancer health economics research. This rapidly developed to the larger question: how should the field of cancer health economics research grow and develop? Addressing this question required wide-ranging input from stakeholders across the cancer control continuum. Multiple perspectives, including those from researchers, clinicians, patients, caregivers, patient advocates, and policy makers, from a range of organizations were needed. To bring everyone together, a natural approach was to hold a conference, optimistically (if somewhat presumptuously) called The Future of Cancer Health Economics Research. Leadership of the NCI Division of Cancer Control and Population Sciences (DCCPS), the Healthcare Delivery Research Program, and the Healthcare Assessment Research Branch was extremely supportive of this conference. Conference planning began with a core group: myself, Donatus “Don” Ekwueme from the Centers for Disease Control and Prevention, Ya-Chen Tina Shih from the University of Texas MD Anderson Cancer Center, and Robin Yabroff from the American Cancer Society. We quickly decided the conference should not simply be a summary of existing research but should focus on actionable steps for moving the field of cancer health economics research forward. The core goals of the conference would be: Identify challenges, gaps, and unmet needs for conducting cancer health economics research Develop suggestions and ideas to address the identified challenges and to support the further development of this field Multiple individuals inside and outside of NCI provided encouragement, feedback, support, and ideas for the conference. Originally planned as an in-person meeting for July 2020, we pivoted to a virtual conference held December 2-3, 2020, because of the COVID-19 pandemic. This change to a virtual event was initially disappointing, however, it allowed for greater participation by many individuals who might not otherwise have attended the conference. Conference planning involved 3 parallel tracks: organizing committees; panels and breakout sessions; and preconference activities. Four organizing committees were formed in alignment with the cancer control continuum: Prevention (led by Donatus Ekwueme), Screening/Diagnosis (led by Ya-Chen Tina Shih), Treatment (led by Robin Yabroff), and Survivorship (led by Cathy Bradley from the University of Colorado). Each organizing committee was responsible for considering the conference goals (challenges for conducting cancer health economics research and suggestions to move the field forward) within its specific area of the cancer control continuum. Based on these deliberations, each committee developed a brief conference presentation designed to summarize the current state of research within its area and to stimulate an interactive discussion among online participants. In parallel, individuals who had expressed interest in this conference were contacted to elicit suggestions for panels and breakout sessions. Joe Lipscomb from Emory University suggested an ideal framework for the panels, What do we need to succeed? That is, what does the field of cancer health economics research need to grow and flourish in the future? Using this framework, we identified 3 panel topics: Communicating health economics research to nonresearcher audiences, led by Yousuf Zafar of Duke University New data infrastructures, resources, and linkages, led by Scott Ramsey of University of Washington Conducting cancer health economics research with a goal of enhancing health equity, co-led by Cathy Bradley and Karen Winkfield of the Meharry-Vanderbilt Alliance Multiple individuals also provided suggestions for conference breakout sessions (and volunteered to lead or co-lead sessions). These were named Action Breakout Sessions, to emphasize their goal of identifying actionable next steps to enhance cancer health economics research. Four such sessions were held at the conference: Development, organization, and structure of training programs for cancer health economics research, co-led by Oliver Bogler of NCI’s Center for Cancer Training, Lindsay Sabik of the University of Pittsburgh, and Courtney Williams of NCI’s Cancer Prevention Fellowship Program Fostering interdisciplinary and transdisciplinary collaborations in cancer health economics research, co-led by Gila Neta of NCI DCCPS and James Yu of Yale University Improving data accessibility for health economics research without compromising data security, co-led by Michael Pesko of Georgia State University and Debra Ritzwoller of Kaiser Permanente Institute for Health Research Methods and study design for cancer health economics research, co-led by Henry (Joe) Henk of OptumLabs and Ya-Chen Tina Shih With the outpouring of ideas and enthusiasm for breakout sessions, we also scheduled networking discussions sessions as part of the conference. These were opportunities to meet (virtually) with other conference attendees sharing interest in a specific topic, similar to meeting with a group of colleagues in a hallway during an in-person meeting. Five informal networking discussions sessions were scheduled: Creating a data warehouse, led by Henry (Joe) Henk Data linkages, led by Lindsey Enewold of NCI DCCPS Employment outcomes, financial hardship, and caregiver economic burden in cancer, co-led by Janet de Moor of NCI DCCPS and Victoria Blinder of Memorial Sloan Kettering Cancer Center Implementation science and health economics, co-led by Gila Neta of NCI DCCPS and Heather Gold of New York University The health economics of end-of-life and palliative care: building a research agenda, led by Jeri Miller of the National Institute of Nursing Research While the conference planning was underway, 3 preconference activities were also initiated. First, to better understand NCI’s recent activities supporting cancer health economics research, Priyanga Tuovinen and Sharon McCarthy of the NCI DCCPS and myself performed a portfolio review of NCI-funded grants that included economic analysis. Details of this portfolio review are presented as a separate paper in this supplement. Also, to better understand the broad landscape of cancer health economics research, Amy Davidoff of the NCI DCCPS, in collaboration with Katie Akif (a presidential management fellow at NCI) and myself, conducted a meta-review summarizing published review articles in this field. Details of this meta-review are also presented as a separate paper in this supplement. The conference agenda and recordings from many of the sessions are available at https://healthcaredelivery.cancer.gov/heroic/conference.html. Finally, in the course of planning the conference, it became clear that cancer health economics research had different meanings to different researchers. For the conference, it would be useful to have common domains and scope for discussions of this field. A small group of individuals collaborated to prepare a framework for cancer health economics research. This group intentionally did not try to create a set definition for this field; rather, the group hoped to develop a working structure to help identify topics and research questions of greatest interest to the conference. This framework was published in Cancer the week prior to the conference (4). This framework illustrates key economic inputs for cancer health economics research across the cancer control continuum; patient, payer, provider, health-care system, and societal-level outcomes frequently considered in cancer health economics research; and structural and policy factors that influence the relationship between these input and outputs. A key take-away from this framework is that the field of cancer health economics research includes but extends well beyond examination of costs and cost-effectiveness. This field incorporates the impacts of policies, programs, and multiple factors on cancer-related services as well as the role of economic factors on health equity, quality of care, and patient outcomes related to cancer. The breadth and diversity of cancer health economics research is reflected in the conference agenda (described above) and the multiple papers included in this supplement. This supplement represents a unique collaborative effort, bringing together a remarkable group of individuals with shared interests in enhancing cancer health economics research to help improve both patient outcomes and the health-care system broadly. The NCI-hosted Future of Cancer Health Economics Research virtual conference was an important step to plan approaches for enhancing the critical role of this field across the cancer control continuum. Thanks to the dedication of all those who supported and participated in this conference and related activities, including this supplement, we have strengthened our understanding of what is cancer health economics research, what has been achieved to date, and how this field can develop to provide even greater contributions in the future. Funding None. Notes Role of the funder: No funding was received for this study and the author indicates no conflicts of interest. Disclaimers: The views expressed here are those of the author do not necessarily represent any official position of the National Cancer Institute or National Institutes of Health. References 1 National Cancer Institute. National Cancer Institute overview and mission. https://www.cancer.gov/about-nci/overview. Accessed July 29, 2021 . 2 Mariotto AB , Enewold L, Zhao J, et al. Medical care costs associated with cancer survivorship in the United States . Cancer Epidemiol Biomarkers Prev . 2020 ; 29 ( 7 ): 1304 – 1312 . Google Scholar Crossref Search ADS PubMed WorldCat 3 Jagsi R , Pottow JA, Griffith KA, et al. Long-term financial burden of breast cancer: experiences of a diverse cohort of survivors identified through population-based registries . J Clin Oncol . 2014 ; 32 ( 12 ): 1269 – 1276 . Google Scholar Crossref Search ADS PubMed WorldCat 4 Halpern MT , Shih YT, Yabroff KR, et al. A framework for cancer health economics research . Cancer . 2021 ; 127 ( 7 ): 994 – 996 . Google Scholar Crossref Search ADS PubMed WorldCat Published by Oxford University Press 2022. This work is written by (a) US Government employee(s) and is in the public domain in the US. This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model) Published by Oxford University Press 2022. This work is written by (a) US Government employee(s) and is in the public domain in the US.

Journal

JNCI MonographsOxford University Press

Published: Jul 5, 2022

References