Gary Schwitzer's HealthNewsReview Blog  (fully funded by the for profit HealthDialog, a point I raise only because Schwitzer makes a federal case about pharma funding of researchers) runs  healthnewsreview.org.   He has never found a new drug or treatment worth paying for.  Which raises the question of whether or not he would accept the state of medicine in 1980. 

Given the guest blog by "Harold DeMonaco, director of the Innovation Support Center at the Massachusetts General Hospital and one of Schwitzer's most active expert story reviewers on HealthNewsReview.org, my guess is he would be delighted to have stopped progress in it's track in 1980.  DeMarco said: "Can we afford to continue to pay for treatments that provide what many would call a marginal benefit? Can we afford not to? Although the increase in survival was only 4 months (from 21 months to 25 months), some men survived longer."

I am shocked at how uninformed the rant against Provenge and other medical breakthroughs was.   In 1980 the average cost for treating colon cancer was $20K, about $42K in 2010.  In 1980 the average five year survival rate for colorectal cancer was 50 percent for people age 45 and over among patients whose cancer had spread to lymph nodes  Today the average cost of colon cancer therapy is $40K with a 5 year survival rate  at a similar stage is 70 percent.  The age-adjusted death rate was 17.6 per 100,000 men and women per year. These rates are based on patients who died in 2003-2007 in the US.  

Advances in interceding years provided, as you described Provenge (which has extended the life expectancy of end stage prostate cancer patients by 2 years) marginal benefit.  That’s on top of a decline in mortality rates from previous treatments and increase screening.

David Cutler noted that “age-adjusted cancer mortality increased by 8 percent between 1971 and 1990, twice the increase from 1950 through 1971. However, between 1990 and 2004, age-adjusted cancer mortality fell by 13 percent. This drop translates into an increase in life expectancy at birth of half a year--roughly a quarter of the two-year increase in life expectancy over this time period and a third of the increase in life expectancy at age 45.”   Similarly,  Murphy and Topel estimate that a 1 percent reduction in cancer mortality would be worth $500 billion.  Since the death rate from prostate cancer has decline by 37 percent since 1992, the worth of that reduction is $18 trillion.

So would you not have spent more money on increasingly more expensive drugs because at that point in time the benefits were marginal. 

That begs the question: would he forfeit the gains in health derived by increased screening and better drugs over the past 30 years to buy more of the kind of cancer care we had in 1980.  Or his just willing to forfeit gains going forward.